TCT-150 New Multiple Risk Scoring System for Predicting 3-Year Major Adverse Cardiac Events Based on 3,281 Patients With Acute Myocardial Infarction Treated With Contemporary PCI and Optimal Medical Therapy: Insights from J-MINUET Study

Abstract Background/objectives Pericoronary adipose tissue inflammation might lead to the development and destabilization of coronary plaques in prediabetic patients. Here, we evaluated inflammation and leptin to adiponectin ratio in pericoronary fat from patients subjected to coronary artery bypass grafting (CABG) for acute myocardial infarction (AMI). Furthermore, we compared the 12-month prognosis of prediabetic patients compared to normoglycemic patients (NG). Finally, the effect of metformin therapy on pericoronary fat inflammation and 12-months prognosis in AMI-prediabetic patients was also evaluated. Methods An observational prospective study was conducted on patients with first AMI referred for CABG. Participants were divided in prediabetic and NG-patients. Prediabetic patients were divided in two groups; never-metformin-users and current-metformin-users receiving metformin therapy for almost 6 months before CABG. During the by-pass procedure on epicardial coronary portion, the pericoronary fat was removed from the surrounding stenosis area. The primary endpoints were the assessments of Major-Adverse-Cardiac-Events (MACE) at 12-month follow-up. Moreover, inflammatory tone was evaluated by measuring pericoronary fat levels of tumor necrosis factor-α (TNF-α), sirtuin 6 (SIRT6), and leptin to adiponectin ratio. Finally, inflammatory tone was correlated to the MACE during the 12-months follow-up. Results The MACE was 9.1% in all prediabetic patients and 3% in NG-patients. In prediabetic patients, current-metformin-users presented a significantly lower rate of MACE compared to prediabetic patients never-metformin-users. In addition, prediabetic patients showed higher inflammatory tone and leptin to adiponectin ratio in pericoronary fat compared to NG-patients (P < 0.001). Prediabetic never-metformin-users showed higher inflammatory tone and leptin to adiponectin ratio in pericoronary fat compared to current-metformin-users (P < 0.001). Remarkably, inflammatory tone and leptin to adiponectin ratio was significantly related to the MACE during the 12-months follow-up. Conclusion Prediabetes increase inflammatory burden in pericoronary adipose tissue. Metformin by reducing inflammatory tone and leptin to adiponectin ratio in pericoronary fat may improve prognosis in prediabetic patients with AMI. Trial registration Clinical Trial NCT03360981, Retrospectively Registered 7 January 2018

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Impact of Admission Glycemic Variability, Glucose, and Glycosylated Hemoglobin on Major Adverse Cardiac Events After Acute Myocardial Infarction

Diabetes Care ◽

10.2337/dc12-0925 ◽

2013 ◽

Vol 36 (4) ◽

pp. 1026-1032 ◽

Cited By ~ 81

Author(s):

G. Su ◽

S.-h. Mi ◽

H. Tao ◽

Z. Li ◽

H.-X. Yang ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Glycosylated Hemoglobin ◽

Glycemic Variability ◽

Major Adverse Cardiac Events ◽

Cardiac Events ◽

Adverse Cardiac Events

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Participation in Disease Management Programs and Major Adverse Cardiac Events in Patients After Acute Myocardial Infarction.

10.21203/rs.3.rs-25395/v1 ◽

2020 ◽

Author(s):

Christian Fischer ◽

Jens Höpner ◽

Saskia Hartwig ◽

Michel Noutsias ◽

Rafael Mikolajczyk

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Disease Management ◽

Cardiac Rehabilitation ◽

Lower Risk ◽

Major Adverse Cardiac Events ◽

Cardiac Events ◽

Disease Management Programs ◽

Cardiovascular Morbidity And Mortality ◽

Adverse Cardiac Events

Abstract Background Cardiovascular diseases are still the main cause of death in the western world. However, diminishing mortality rates of acute myocardial infarction (AMI) are motivating the need to investigate the process of stationary and ambulatory secondary prevention after AMI. Besides cardiac rehabilitation, disease management programs (DMPs) are an important component of outpatient care after AMI in Germany. This study aims to analyze outcomes after AMI among those who participated in DMPs and stationary cardiac rehabilitation (CR) in a region with overall increased cardiovascular morbidity and mortality. Methods: On the basis of data from a regional myocardial infarction registry and a 2-years follow up period, we assessed the occurrence of major adverse cardiac events (MACE) in relation to participation in CR and DMP, risk factors for complications and individual health, and lifestyle characteristics. Multivariable Cox regression was performed to compare survival time until an adverse event occurred.Results Out of 1,094 observed patients AMI, 272 were enrolled in a DMP. A weak association between DMP participation and hazard rates for MACE compared to non-enrollees was found in the crude model (hazard ratio = 0.93; 95% confidence interval = 0.65–1.33). When adjusted for possible confounders, this difference disappeared (1.03; 0.72–1.48). Furthermore, smokers and obese patients showed a distinctly lower chance of DMP enrollment. In contrast, participants of CR showed a lower risk for MACE in crude (0.52; 0.41–0.65) and adjusted analysis (0.56; 0.44–0.71).Conclusions Participation in DMP was not associated with a lower risk of MACE, while CR showed beneficial effects. Adjustment only slightly changed effect estimates in both cases, still potential effects of confounding need to be considered.

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Participation in disease management programs and major adverse cardiac events in patients after acute myocardial infarction. A longitudinal study based on registry data

10.21203/rs.3.rs-25395/v3 ◽

2020 ◽

Author(s):

Christian Fischer ◽

Jens Höpner ◽

Saskia Hartwig ◽

Michel Noutsias ◽

Rafael Mikolajczyk

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Disease Management ◽

Cardiac Rehabilitation ◽

Lower Risk ◽

Major Adverse Cardiac Events ◽

Cardiac Events ◽

Disease Management Programs ◽

Confounding Variables ◽

Adverse Cardiac Events

Abstract Background: Cardiovascular diseases are still the main cause of death in the western world. However, diminishing mortality rates of acute myocardial infarction (AMI) are motivating the need to investigate the process of secondary prevention after AMI. Besides cardiac rehabilitation, disease management programs (DMPs) are an important component of outpatient care after AMI in Germany. This study aims to analyze outcomes after AMI among those who participated in DMPs and cardiac rehabilitation (CR) in a region with overall increased cardiovascular morbidity and mortality. Methods: Based on data from a regional myocardial infarction registry and a 2-year follow-up period, we assessed the occurrence of major adverse cardiac events (MACE) in relation to participation in CR and DMP, risk factors for complications and individual healthas well as lifestyle characteristics. Multivariable Cox regression was performed to compare survival time between participants and non-participants until an adverse event occurred. Results: Of 1,094 observed patients post-AMI, 272 were enrolled in a DMP. An association between DMP participation and lower hazard rates for MACE compared to non-enrollees could not be proven in the crude model (hazard ratio = 0.93; 95% confidence interval = 0.65-1.33). When adjusted for possible confounding variables, these results remained virtually unchanged (1.03; 0.72-1.48). Furthermore, smokers and obese patients showed a distinctly lower chance of DMP enrollment. In contrast, those who participated in CR showed a lower risk for MACE in crude (0.52; 0.41-0.65) and adjusted analysis (0.56; 0.44-0.71). Conclusions: Participation in DMP was not associated with a lower risk of MACE, but participation in CR showed beneficial effects. Adjustment only slightly changed effect estimates in both cases, but it is still important to consider potential effects of confounding variables.

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Circulating Platelet-Derived Microparticles Associated with Postdischarge Major Adverse Cardiac Events in ST-Elevation Acute Myocardial Infarction

Cardiology Research and Practice ◽

10.1155/2020/6721584 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Anggoro Budi Hartopo ◽

Dyah Samti Mayasari ◽

Ira Puspitawati ◽

Hasanah Mumpuni

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Major Adverse Cardiac Events ◽

Cardiac Events ◽

Prognostic Implication ◽

Adverse Cardiac Events ◽

St Elevation ◽

Elevation Acute Myocardial Infarction

Introduction. Platelet-derived microparticles (PDMPs) measurement adds prognostic implication for ST-elevation acute myocardial infarction (STEMI). The long-term implication of PDMPs in STEMI needs to be corroborated. Methods. The research design was a cohort study. Subjects were STEMI patients and were enrolled consecutively. The PDMPs were defined as microparticles bearing CD41(+) and CD62P(+) markers detected with flow cytometry. The PDMPs were measured on hospital admission and 30 days after discharge. The outcomes were major adverse cardiac events (MACE), i.e., a composite of cardiac death, heart failure, cardiogenic shock, reinfarction, and resuscitated ventricular arrhythmia, occurring from hospitalization until 1 year after discharge. Results. We enrolled 101 subjects with STEMI. During hospitalization, 17 subjects (16.8%) developed MACE. The PDMPs were not different between subjects with MACE and those without (median (IQR): 3305.0/μL (2370.0–14690.5/μL) vs. 4452.0/μL (2024.3–14396.8/μL), p=0.874). Forty-five subjects had increased PDMPs in 30 days after discharge as compared with on-admission measurement. Subjects with increased PDMPs had significantly higher 30-day MACE as compared to subjects with decreased PDMPs 17 (37.8%) vs. 6 (16.7%, p=0.036). There was a trend toward higher MACE in subjects with increased PDMPs as compared to those with decreased PDMPs in 90 days after discharge (48.9% vs. 30.6%, p=0.095) and 1 year after discharge (48.9% vs. 36.1%, p=0.249). Conclusion. The PDMPs level was increased from the day of admission to 30 days after discharge in patients with STEMI. The persistent increase in the PDMPs level in 30 days after the STEMI event was associated with the 30-day postdischarge MACE and trended toward increased MACE during the 90-day and 1-year follow-up.

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