Risk factors for a new cardiac event after a first acute coronary syndrome

2016 ◽  
Vol 33 (S1) ◽  
pp. S393-S394 ◽  
Author(s):  
P. Ossola ◽  
F. Scagnelli ◽  
A. Longhi ◽  
C. De Panfilis ◽  
M. Tonna ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Risk Factor ◽  
Depressive Episode ◽  
Cardiac Event ◽  
Significant Risk ◽  
Anxiety And Depression ◽  
Cardiac Events ◽  
Coronary Syndrome ◽  
Depressive Episodes ◽  
Grace Score

IntroductionDepression is an established risk factor for acute coronary syndrome (ACS), nonetheless the mechanisms underlying this association are still unclear and literature disagrees on the role played by anxiety. Moreover, most of the studies included subjects with a long lasting history of heart disease or recurrent depressive episodes that could bias the results.ObjectivesWe performed serial assessments of anxiety, depression and new cardiac events in a cohort of never-depressed patients in the two years after their first ACS.AimsClarify the role of anxiety and depression in predicting new cardiac events.MethodsTwo hundred and fifty-one consecutive patients completed the two-years follow-up. The presence of depression was evaluated with the Primary Care Evaluation of Mental Disorders (PRIME-MD) and its severity with the Hospital Anxiety and Depression Scale (HADS). Evaluations were collected at baseline, when GRACE-score was calculated, and at 1, 2, 4, 6, 9, 12 and 24-months follow-ups.ResultsForty-two patients (16.7%) developed a second cardiac event and, of these, eighteen (42.9%) had a previous depressive episode. At Cox Regression, controlling for confounding clinical variables (e.g. GRACE-score), developing a first-ever depressive episode was a significant risk factor (OR = 2.38; 95%CI = 1.11–5.14; P = 0.027) whereas baseline anxiety was protective (OR = 0.56; 95%CI = 0.38–0.81; P= 0.002). The latter, moreover, moderated the effect of incident depression on new cardiac events.ConclusionOur results confirm the well-established detrimental effect of depression on cardiac prognosis and suggest clinicians to keep in mind anxious symptoms when facing a patient at his/her first ACS.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Sex Difference in Risk Factors, GRACE Scores, and Management among Post-Acute Coronary Syndrome Patients in Sri Lanka

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Priyadarshani Galappatthy ◽  
Vipula Bataduwaarachchi ◽  
Priyanga Ranasinghe ◽  
Gamini Galappatthy ◽  
Upul Senerath ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Risk Factor ◽  
Sri Lanka ◽  
Disease Risk ◽  
Management Strategies ◽  
Significant Proportion ◽  
Coronary Syndrome ◽  
One Year ◽  
Grace Score

Objective. To assess sex-based differences in the prevalence of risk factor, their management, and differences in the prognosis among acute coronary syndrome (ACS) in Sri Lanka. Methods. Patients diagnosed with ACS were recruited from hospitals throughout the island. The Joint European Societies guidelines were used to assess recommended targets for coronary heart disease risk factors, and the GRACE score was used to assess the post-ACS prognosis. Age-adjusted regression was performed to calculate odds ratios for men versus women in risk factor control. Results. A total of 2116 patients, of whom 1242 (58.7%) were men, were included. Significant proportion of women were nonsmokers; OR = 0.11 (95% CI 0.09 to 0.13). The prevalence of hypertension (p<0.001), diabetes (p<0.001), and dyslipidemia (p=0.004) was higher in women. The LDL-C target was achieved in a significantly higher percentage of women (12.6%); OR = 0.33 (95% CI 0.10 to 1.05). When stratified by age, no significant differences were observed in achieving the risk factor targets or management strategies used except for fasting blood sugar (p<0.05) where more men achieved control target in both age categories. Majority of the ACS patients had either high or intermediate risk for one-year mortality as per the GRACE score. In-hospital and 1-year mean mortality risk was significantly higher among men of less than 65 years of age (p<0.05). Conclusions. Smoking is significantly lower among Sri Lankan women diagnosed with ACS. However, hypertension, diabetes, and dyslipidemia were more prevalent among them. There was no difference in primary and secondary preventive strategies and management in both sexes but could be further improved in both groups.

scholarly journals Risk Stratification and in Hospital Morality in Patients Presenting with Acute Coronary Syndrome (ACS) in Bahrain

2018 ◽  
Vol 12 (1) ◽  
pp. 7-17 ◽  
Author(s):  
Taysir S Garadah ◽  
Khalid Bin Thani ◽  
Leena Sulibech ◽  
Ahmed A Jaradat ◽  
Mohamed E Al Alawi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Hospital Mortality ◽  
Systolic Hypertension ◽  
Cardiac Events ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Positive Serum ◽  
Grace Score

Background: Risk factors and short-term mortality in patients presented with Acute Coronary Syndrome (ACS) in Bahrain has not been evaluated before. Aim: In this prospective observational study, we aim to determine the clinical risk profiles of patients with ACS in Bahrain and describe the incidence, pattern of presentation and predictors of in-hospital clinical outcomes after admission. Methods: Patients with ACS were prospectively enrolled over a 12 month period. The rate of incidence of risk factors in patients was compared with 635 non-cardiac patient admissions that matched for age and gender. Multiple logistic regression analysis was used to predict poor outcomes in patients with ACS. The variables were ages >65 years, body mass index (BMI) >28 kg/m2, GRACE (Global Registry of Acute Coronary Events) score >170, history of diabetes mellitus (DM), systolic hypertension >180 mmHg, level of creatinine >160 μmol/l and Heart Rate (HR) on admission >90 bpm, serum troponin rise and ST segment elevation on the ECG. Results: Patients with ACS (n=635) were enrolled consecutively. Mean age was 61.3 ± 13.2 years, with 417 (65.6%) male. Mean age for patients with ST-segment elevation myocardial infarction (STEMI, n=156) compared with non-STEMI (NSTEMI, n=158) and unstable angina (UA, n=321) was 56.5± 12.8 vs 62.5±14.0 years respectively. In-hospital mortality was 5.1%, 3.1% and 2.5% for patients with STEMI, NSTEMI, and UA, respectively. In STEMI patients, thrombolytic therapy was performed in 88 (56.5%) patients and 68 (43.5%) had primary coronary angioplasty (PCI). The predictive value of different clinical variables for in-hospital mortality and cardiac events in the study were: 2.8 for GRACE score >170, 3.1 for DM, 2.2 for SBP >180 mmHg, 1.4 for age >65 years, 1.8 for BMI >28, 1.7 for creatinine >160 μmol/L, 2.1 for HR >90 bpm, 2.2 for positive serum troponin and 2.3 for ST elevation. Conclusion: Patients with STEMI compared with NSTEMI and UA were of younger age. There was higher in-hospital mortality in STEMI compared with NSTEMI and UA patients. The most significant predictors of death or cardiac events on admission in ACS were DM, GRACE Score >170, systolic hypertension >180 mmHg, positive serum troponin and HR >90 bpm.

scholarly journals Association between serum S100A1 level and Global Registry of Acute Coronary Events score in patients with non-ST-segment elevation acute coronary syndrome

2018 ◽  
Vol 46 (7) ◽  
pp. 2670-2678
Author(s):  
Yuanmin Li ◽  
Chenjun Han ◽  
Peng Zhang ◽  
Wangfu Zang ◽  
Rong Guo
Keyword(s):  
Acute Coronary Syndrome ◽  
Venous Blood ◽  
Cardiac Events ◽  
Coronary Syndrome ◽  
Kaplan Meier ◽  
St Segment ◽  
Potential Biomarker ◽  
Coronary Events ◽  
Global Registry ◽  
Grace Score

Objective Acute coronary syndrome (ACS) is associated with several clinical syndromes, one of which is acute non-ST-segment ACS (NSTE-ACS). S100A1 is a calcium-dependent regulator of heart contraction and relaxation. We investigated the association between the serum S100A1 level and the Global Registry of Acute Coronary Events (GRACE) risk score in patients with NSTE-ACS and the potential of using the serum S100A1 level to predict the 30-day prognosis of NSTE-ACS. Methods The clinical characteristics of 162 patients with NSTE-ACS were analyzed to determine the GRACE score. The serum S100A1 concentration was determined using fasting antecubital venous blood. The patients were divided into different groups according to the serum S100A1 level, and the 30-day NSTE-ACS prognosis was evaluated using Kaplan–Meier analysis. Results The serum S100A1 levels differed significantly among the groups. Correlation analysis showed that the serum S100A1 level was positively correlated with the GRACE score. Kaplan–Meier analysis revealed that the number of 30-day cardiac events was significantly higher in patients with an S100A1 level of >3.41 ng/mL. Conclusions S100A1 is a potential biomarker that can predict the progression of NSTE-ACS and aid in its early risk stratification and prognosis.

Components of Type a Behavior and Two-Year Prognosis of Patients with Acute Coronary Syndrome

2001 ◽  
Vol 89 (3) ◽  
pp. 467-475 ◽  
Author(s):  
Katija Čatipović-Veselica ◽  
Blanka Glavaš ◽  
Jozo Kristek ◽  
Miroslav Šram
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Cardiac Event ◽  
Type A ◽  
Type A Behavior ◽  
Type B ◽  
Cardiac Events ◽  
Coronary Syndrome

We investigated prospectively the relationship of Type A behavior and its subcomponents with cardiac mortality and recurrent nonfatal cardiac events in a 2-yr. follow-up of 90 patients [69 men and 21 women, M age = 56.4 yr., SD = 8.4] after acute coronary syndrome. Type A behavior was assessed via the general Bortner Type A Index. Each patient completed the Bortner's scale before hospital discharge During the first 2-yr. follow-up, there were 14 cardiac deaths among patients with myocardial infarction. 8 patients had recurrent cardiac events and were hospitalized, and 19 patients had an effort-induced angina pectoris. Patients with acute myocardial infarction who died during follow-up had a significantly lower Bortner score than patients with a secondary cardiac event. Bortner scores of patients with acute myocardial infarction who died indicated Type B behavioral patterns. Mortality was significantly higher in the patients classified as showing Type B (21.8%) behavior than in the patients classified as showing Type A (12.0%) behavior. Patients with a secondary cardiac event had more common Type A behavior patterns and higher Bortner scores than patients without a secondary cardiac event. The items on Bortner's scale “very competitive, ever rushed, tries to do too many things at once, fast in daily activities and expresses feelings” were inversely associated with cardiac deaths. These findings suggest that patients with acute coronary syndrome classified by scores on the Bortner scale as Type B behavior have a greater probability of death, and patients classified on the Bortner scale as Type A behavior have a greater probability of secondary cardiac events during follow-up. This finding may have implications for the treatment of patients with acute coronary syndrome. The inferior survival of patients with Type B personalities argues against attempts to modify Type A behavior in postinfarction patients.

Usefulness of late diastolic mitral annular velocity for predicting cardiac events in acute coronary syndrome patients with dilated left atrium

Choonpa Igaku ◽  
2010 ◽  
Vol 37 (5) ◽  
pp. 577-585
Author(s):  
Hideaki MATSUURA ◽  
Akira YAMADA ◽  
Kunihiko SUGIMOTO ◽  
Yoshimi OHIRA ◽  
Ayako TAKAHASHI ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Left Atrium ◽  
Cardiac Events ◽  
Coronary Syndrome ◽  
Mitral Annular Velocity

scholarly journals Usefulness of the PRECISE DAPT score as a predictor of ischaemic stroke after an acute coronary syndrome

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Gonzalez Ferrero ◽  
B.A.A Alvarez Alvarez ◽  
C.C.A Cacho Antonio ◽  
M.P.D Perez Dominguez ◽  
P.A.M Antunez Muinos ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Ischaemic Stroke ◽  
Independent Predictor ◽  
Multivariable Logistic Regression Analysis ◽  
Funding Source ◽  
Independent Factor ◽  
Prediction Ability ◽  
Coronary Syndrome ◽  
Grace Score

Abstract Introduction Ischaemic stroke (IS) risk after acute coronary syndrome is increasing. The aim of our study was to evaluate the stroke rate in a multicentre study and to determine the prediction ability of the PRECISE DAPT score, added to the prediction power of the GRACE score, already demonstrated. Methods This was a retrospective study, carried out in two centres with 5916 patients, with ACS discharged between 2011 and 2017 (median 66±13 years, 27.7% women). The primary endpoint was the occurrence of ischaemic stroke and its risk during follow up (median 5.5, IQR 2.6–7.0). Results A multivariable logistic regression analysis was made, where GRACE (HR 1.01, IC 95% 1.00–1.02) and PRECISE DAPT score (HR 1.03, IC 95% 1.01–1.05) were both an independent predictor of ischaemic stroke after ACS, in a model adjusted by age and AF, which was found to be the independent factor with highest risk (HR 1.67, IC 95% 1.09–2.55). Conclusions GRACE and PRECISE DAPT scores are ischaemic stroke predictors used during follow-up for patients after acute coronary syndrome. We should use both of them not only trying to predict ischaemic/haemorrhagic risk respectively but also as ischaemic stroke predictors. Figure 1. AUC Curves Funding Acknowledgement Type of funding source: None

scholarly journals Myocardial Bridging, the Hidden Risk Factor for Ischemia

2021 ◽  
Author(s):  
Vincenzo C Happach ◽  
Gerald T Delk ◽  
Latha Ganti
Keyword(s):  
Emergency Department ◽  
Acute Coronary Syndrome ◽  
Risk Factor ◽  
Military Service ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Service Member ◽  
Myocardial Bridging ◽  
Coronary Syndrome ◽  
Military Service Member

ABSTRACT Myocardial bridging is an uncommon cause of a quite common emergency department complaint for chest pain and is often associated with left ventricular hypertrophy. We present a case of an otherwise healthy middle-aged U.S. military service member who presented with acute coronary syndrome which was ultimately determined to be the result of myocardial bridging.

Small dense low density lipoprotein as a new novel risk factor for acute coronary syndrome

2011 ◽  
Vol 44 (13) ◽  
pp. S61
Author(s):  
Alavi Maryam Sadat ◽  
Emadzadeh Mahdi Reza ◽  
Ghayour Mobarhan Majid ◽  
Soukhtanloo Mohammad ◽  
Parizadeh Mohammad Reza ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Risk Factor ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Low Density ◽  
Coronary Syndrome ◽  
New Novel
Sign in / Sign up

Export Citation Format

Share Document