scholarly journals Risk factors for major adverse cardiovascular events after the first acute coronary syndrome

2021 ◽  
Vol 53 (1) ◽  
pp. 817-823
Author(s):  
Marjo Okkonen ◽  
Aki S. Havulinna ◽  
Olavi Ukkola ◽  
Heikki Huikuri ◽  
Arto Pietilä ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Cardiovascular Events ◽  
Major Adverse Cardiovascular Events ◽  
Coronary Syndrome

scholarly journals Prognostic Value of Admission Mean Corpuscular Volume for Major Adverse Cardiovascular Events following Stent Implantation in Nondiabetic and Diabetic Patients with Acute Coronary Syndrome

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Lele Cheng ◽  
Lisha Zhang ◽  
Junhui Liu ◽  
Wenyuan Li ◽  
Xiaofang Bai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Stent Implantation ◽  
Cardiovascular Events ◽  
Mean Corpuscular Volume ◽  
Major Adverse Cardiovascular Events ◽  
Diabetic Patients ◽  
Corpuscular Volume ◽  
Coronary Syndrome

Background. One of the key concerns of the clinician is to identify and manage risk factors for major adverse cardiovascular events (MACEs) in nondiabetic and diabetic patients with acute coronary syndrome (ACS) undergoing stent implantation. Mean corpuscular volume (MCV) is a marker of erythrocyte size and activity and is associated with prognosis of cardiovascular disease. However, the role of admission MCV in predicting MACEs following stent implantation in diabetes mellitus (DM), non-DM, or whole patients with ACS remains largely unknown. Methods and Results. A total of 437 ACS patients undergoing stent implantation, including 294 non-DM (59.08±10.24 years) and 143 DM (63.02±9.92 years), were analyzed. Admission MCV was higher in non-DM than DM patients. During a median of 31.93 months follow-up, Kaplan-Meier curve demonstrated that higher admission MCV level was significantly associated with increased MACEs in whole and non-DM, but not in DM patients. In Cox regression analysis, the highest MCV tertile was associated with higher MACEs in whole ([HR] 1.870, 95% CI 1.113-3.144, P=0.018), especially those non-DM ([HR] 2.089, 95% CI 1.077-4.501, P=0.029) patients after adjustment of several cardiovascular risk factors. MCV did not predict MACEs in DM patients. During landmark analysis, admission MCV showed better predictive value for MACEs in the first 32 months of follow-up than in the subsequent period. Finally, the receiver operating characteristic (ROC) curve was conducted to confirmed the value of admission MCV within 32 months. Conclusion. In patients with ACS, elevated admission MCV is an important and independent predictor for MACEs following stent implantation, especially amongst those without DM even after adjusting for lifestyle and clinical risk factors. However, as the follow-up period increased, the admission MCV lost its ability to predict MACEs.

Homocysteine as a potential predictive factor for high major adverse cardiovascular events risk in female patients with premature acute coronary syndrome

2019 ◽  
Author(s):  
Mei Wei ◽  
Le Wang ◽  
Yongsheng Liu ◽  
Mingqi Zheng ◽  
Fangfang Ma ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Predictive Factor ◽  
Cardiovascular Events ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Major Adverse Cardiovascular Events ◽  
Free Survival ◽  
Female Patients ◽  
Coronary Syndrome ◽  
Kaplan Meier

Abstract Background We aimed to investigate correlation of homocysteine (Hcy) level with clinical characteristics, and explore its predictive value for major adverse cardiovascular events (MACE) risk in female patients with premature acute coronary syndrome (ACS).Methods Serum Hcy level was detected from 1,299 female patients with premature ACS. According to the tertile of Hcy level, patients were divided into three groups: lowest tertile group (≤9.1 µmol/L), middle tertile group (9.2~11.6 µmol/L) and highest tertile group (>11.6 µmol/L). MACE incidence was recorded and MACE-free survival was caculated with the median follow-up duration of 28.3 months.Results Increased Hcy correlated with older age ( P <0.001), higher creatinine level ( P <0.001) and enhanced uric acid level ( P =0.001), while reduced fasting glucose concentration ( P <0.001). MACE incidence was 10.7% and it was highest in highest tertile group (22.1%), followed by middle tertile group (7.7%) and lowest tertile group (2.4%) ( P <0.001). Receiver operating characteristic curve showed that Hcy distinguished MACE patients from non-MACE patients with the area under the curve of 0.789 (95% CI: 0.742-0.835). Kaplan-Meier curves revealed that MACE-free survival was shortest in Hcy highest tertile group, followed by middle tertile group and lowest tertile group ( P <0.001). Multivariate Cox’s analyses further showed that higher Hcy level was an independently predictive factor for poor MACE-free survival (middle tertile vs. lowest tertile ( P =0.001, HR: 3.615, 95% CI: 1.661-7.864); highest tertile vs. lowest tertile ( P <0.001, HR: 11.023, 95% CI: 5.356-22.684)).Conclusion Hcy serves as a potential predictive factor for increased MACE risk in female patients with premature ACS.

Long-Term Risk of Major Adverse Cardiovascular Events in Patients With Acute Coronary Syndrome: Prognostic Role of Complete Blood Cell Count

Angiology ◽  
2020 ◽  
Vol 71 (9) ◽  
pp. 831-839
Author(s):  
Nuccia Morici ◽  
Valentina Molinari ◽  
Silvia Cantoni ◽  
Andrea Rubboli ◽  
Laura Antolini ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
High Risk ◽  
Blood Cell ◽  
Cardiovascular Events ◽  
Major Adverse Cardiovascular Events ◽  
Blood Cell Count ◽  
Prognostic Role ◽  
Coronary Syndrome

Individual parameters of complete blood count (CBC) have been associated with worse outcome in patients with acute coronary syndrome (ACS). However, the prognostic role of CBC taken as a whole has never been evaluated for long-term incidence of major adverse cardiovascular events (MACEs). Patients were grouped according to their hematopoietic cells’ inflammatory response at different time points during hospital stay. Patients with admission white blood cell count >10 × 109/L, discharge hemoglobin <120 g/L, and discharge platelet count >250 × 109/L were defined as “high-risk CBC.” Among 1076 patients with ACS discharged alive, 129 (12%) had a “high-risk CBC” and 947 (88%) had a “low-risk CBC.” Patients with “high-risk CBC” were older and had more comorbidities. Over a median follow-up of 665 days, they experienced a higher incidence of MACE compared to “low-risk CBC” patients (18.6% vs 8.1%). After adjustment for age, age-adjusted Charlson comorbidity index, female sex, cardiac arrest, suboptimal discharge therapy, coronary artery bypass, and ejection fraction, a high-risk CBC was significantly associated with increased MACE occurrence (adjusted hazard ratio 1.80; 95% CI: 1.09-3.00). The CBC was a prognostic marker in patients with ACS, and its evaluation at admission and discharge could better classify patient’s risk and improve therapeutic management.

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