Subsequent Major Adverse Cardiac Events in Patients With Clinical Atherosclerotic Cardiovascular Disease and Prior Statin Use

2017 ◽  
Vol 11 (3) ◽  
pp. 786
Author(s):  
Brian Boatman ◽  
Stefan DiMario ◽  
Tanya Burton ◽  
Jerald Seare ◽  
Jeetvan Patel ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Major Adverse Cardiac Events ◽  
Atherosclerotic Cardiovascular Disease ◽  
Cardiac Events ◽  
Adverse Cardiac Events ◽  
Statin Use

scholarly journals Association of Kidney Disease With Outcomes in COVID‐19: Results From the American Heart Association COVID‐19 Cardiovascular Disease Registry

2021 ◽  
Author(s):  
Anjali Rao ◽  
Sagar Ranka ◽  
Colby Ayers ◽  
Nicholas Hendren ◽  
Anna Rosenblatt ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Kidney Disease ◽  
Major Adverse Cardiac Events ◽  
Secondary Outcome ◽  
Cardiac Events ◽  
End Stage Kidney Disease ◽  
Adverse Cardiac Events ◽  
All Cause Mortality ◽  
End Stage ◽  
Stage 1

Background Emerging evidence links acute kidney injury (AKI) in patients with COVID‐19 with higher mortality and respiratory morbidity, but the relationship of AKI with cardiovascular disease outcomes has not been reported in this population. We sought to evaluate associations between chronic kidney disease (CKD), AKI, and mortality and cardiovascular outcomes in patients hospitalized with COVID‐19. Methods and Results In a large multicenter registry including 8574 patients with COVID‐19 from 88 US hospitals, data were collected on baseline characteristics and serial laboratory data during index hospitalization. Primary exposure variables were CKD (categorized as no CKD, CKD, and end‐stage kidney disease) and AKI (classified into no AKI or stages 1, 2, or 3 using a modification of the Kidney Disease Improving Global Outcomes guideline definition). The primary outcome was all‐cause mortality. The key secondary outcome was major adverse cardiac events, defined as cardiovascular death, nonfatal stroke, nonfatal myocardial infarction, new‐onset nonfatal heart failure, and nonfatal cardiogenic shock. CKD and end‐stage kidney disease were not associated with mortality or major adverse cardiac events after multivariate adjustment. In contrast, AKI was significantly associated with mortality (stage 1 hazard ratio [HR], 1.72 [95% CI, 1.46–2.03]; stage 2 HR, 1.83 [95% CI, 1.52–2.20]; stage 3 HR, 1.69 [95% CI, 1.44–1.98]; versus no AKI) and major adverse cardiac events (stage 1 HR, 2.17 [95% CI, 1.74–2.71]; stage 2 HR, 2.70 [95% CI, 2.07–3.51]; stage 3 HR, 3.06 [95% CI, 2.52–3.72]; versus no AKI). Conclusions This large study demonstrates a significant association between AKI and all‐cause mortality and, for the first time, major adverse cardiovascular events in patients hospitalized with COVID‐19.

scholarly journals The Role of Sodium Glucose Cotransporter-2 Inhibitors in Atherosclerotic Cardiovascular Disease: A Narrative Review of Potential Mechanisms

Cells ◽  
2021 ◽  
Vol 10 (10) ◽  
pp. 2699
Author(s):  
Jennifer Y Barraclough ◽  
Sanjay Patel ◽  
Jie Yu ◽  
Bruce Neal ◽  
Clare Arnott
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Death ◽  
Sglt2 Inhibitors ◽  
Narrative Review ◽  
Atherosclerotic Cardiovascular Disease ◽  
Cardiac Events ◽  
Sodium Glucose Cotransporter ◽  
Adverse Cardiac Events

Sodium glucose cotransporter 2 (SGLT2) inhibitors are a class of medication with broad cardiovascular benefits in those with type 2 diabetes, chronic kidney disease, and heart failure. These include reductions in major adverse cardiac events and cardiovascular death. The mechanisms that underlie their benefits in atherosclerotic cardiovascular disease (ASCVD) are not well understood, but they extend beyond glucose lowering. This narrative review summarises the ASCVD benefits of SGLT2 inhibitors seen in large human outcome trials, as well as the mechanisms of action explored in rodent and small human studies. Potential pathways include favourable alterations in lipid metabolism, inflammation, and endothelial function. These all require further investigation in large human clinical trials with mechanistic endpoints, to further elucidate the disease modifying benefits of this drug class and those who will benefit most from it.

scholarly journals Masters Athlete Screening Study (MASS): incidence of cardiovascular disease and major adverse cardiac events over five years of screening

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
B N Morrison ◽  
S Isserow ◽  
M MacDonald ◽  
C Cater ◽  
I Zwaiman ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Major Adverse Cardiac Events ◽  
Aortic Dilatation ◽  
Cardiac Events ◽  
Cardiovascular Screening ◽  
Adverse Cardiac Events ◽  
Masters Athletes ◽  
Screening Study ◽  
Masters Athlete

Abstract Background The long-term implications of cardiovascular disease (CVD) in masters athletes, and whether screening decreases their risk of major adverse cardiac events (MACE) is unknown. Purpose To evaluate the incidence of CVD and MACE over five years of a screening study. Methods Masters athletes (≥35 years) from a variety of sports without previous history of coronary artery disease (CAD) underwent yearly cardiovascular screening. The screen consisted of anthropometrics, blood pressure, resting electrocardiogram, modified American Heart Association 14-element recommendations, cardiovascular event questionnaire, physical examination (year 1) and Framingham Risk Score (years 1–3). Participants with an abnormal screen according to the European Association of Cardiovascular Prevention and Canadian Cardiology Society Guidelines underwent further evaluations (computed coronary tomography angiography was not included for all athletes but based on clinical assessment). Participants who withdrew during the study received a follow-up questionnaire to determine MACE and vital status. Results In the first year of the Masters Athlete Screening Study, 798 masters athletes (62.7% male, 54.6±9.5 years) were screened; 91 (11.4%) of the cohort were found to have CVD. CAD was the most common diagnosis (69.2%). During the following four years, there were an additional 89 CVD diagnoses with an incidence rate of 3.58/100, 4.14/100, 3.74/100, 1.19/100, for years two to five, respectively. Fifteen participants had more than one diagnosis. The most common diagnoses over the five years were arrhythmias (n=33; 37.1%), aortic dilatation (n=20; 22.5%), CAD (n=18; 20.2% (5 obstructive, 13 non-obstructive)) and other (n=7; 7.9%) (myocarditis (n=2), myocardial bridging (n=1), cerebrovascular disease (n=1), dilated cardiomyopathy (n=1), probable Long QT syndrome (n=1), papillary fibroelastoma (n=1)). A total of 10 MACE occurred (two cardiovascular deaths, five myocardial infarctions and three cerebrovascular accidents). All events occurred in male athletes (63.6±12.5 years). Out of the 136 participants that received the lost to follow-up questionnaire, 101 (74.3%) completed it. Of those, one male athlete underwent percutaneous coronary intervention. The incidence of MACE over the study period was 0.30/100 athletes per year. Conclusion Yearly cardiovascular screening of masters athletes identified ∼3 new diagnoses per 100 athletes per year. Ten MACE occurred despite yearly screening and high CV fitness of masters athletes. FUNDunding Acknowledgement Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): MITACs and CIHR

scholarly journals Prognostic Value of Systemic Immune-Inflammation Index for Major Adverse Cardiac Events and Mortality in Severe Aortic Stenosis Patients after TAVI

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 588
Author(s):  
Aydin Rodi Tosu ◽  
Muhsin Kalyoncuoglu ◽  
Halil İbrahim Biter ◽  
Sinem Cakal ◽  
Murat Selcuk ◽  
...  
Keyword(s):  
Aortic Stenosis ◽  
Prognostic Value ◽  
Major Adverse Cardiac Events ◽  
Cardiac Events ◽  
Short Term ◽  
Cox Regression Analysis ◽  
Adverse Cardiac Events ◽  
All Cause Mortality ◽  
Auc Value ◽  
Immune Inflammation

Background and objectives: In this study, we aimed to evaluate whether the systemic immune-inflammation index (SII) has a prognostic value for major adverse cardiac events (MACEs), including stroke, re-hospitalization, and short-term all-cause mortality at 6 months, in aortic stenosis (AS) patients who underwent transcatheter aortic valve implantation (TAVI). Materials and Methods: A total of 120 patients who underwent TAVI due to severe AS were retrospectively included in our study. The main outcome of the study was MACEs and short-term all-cause mortality at 6 months. Results: The SII was found to be higher in TAVI patients who developed MACEs than in those who did not develop them. Multivariate Cox regression analysis revealed that the SII (HR: 1.002, 95%CI: 1.001–1.003, p < 0.01) was an independent predictor of MACEs in AS patients after TAVI. The optimal value of the SII for MACEs in AS patients following TAVI was >1.056 with 94% sensitivity and 96% specificity (AUC (the area under the curve): 0.960, p < 0.01). We noted that the AUC value of SII in predicting MACEs was significantly higher than the AUC value of the C-reactive protein (AUC: 0.960 vs. AUC: 0.714, respectively). Conclusions: This is the first study to show that high pre-procedural SII may have a predictive value for MACEs and short-term mortality in AS patients undergoing TAVI.

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