Cardiovascular risk factors as predictors of heart failure during hospitalization for Acute Coronary Syndromes

Abstract Funding Acknowledgements Type of funding sources: None. OnBehalf Portuguese Registry of Acute Coronary Syndromes Background Cardiovascular risk factors (CVRF) are a growing health problem in developed countries. These patients have a higher prevalence of acute coronary syndromes (ACS) and as a consequence ACS complication, like heart failure (HF). HF after an ACS is a common complication and CVFR can influence its manifestation. Objective Evaluate the impact of the CVRF in HF during the hospitalization for ACS. Methods Multicenter retrospective study, based on the Portuguese Registry of ACS between 1/10/2010-4/09/2019. Patients were divided in two groups: A – without new onset of HF during the hospitalization for ACS and B – with new onset of HF during the hospitalization for ACS. CVFR was defined by body mass index, diabetes, arterial hypertension, smoking, neoplasia, dyslipidemia, coronary artery disease, chronic kidney disease and peripheral arterial disease. Logistic regression was performed to assess predictors of new onset HF in these patients. Results 14717 patients were included, 2287 in group B (15.5%). Both groups were similar regarding body mass index (27.5 ± 4.3 vs 27.2 ± 4.4, p = 0.254). Curiously the group A exhibited higher prevalence of smoking status (29.8 vs 16.6%, p < 0.001). On the other hand, group B presented more females (25.0 vs 35.7%, p < 0.001), arterial hypertension (68.7 vs 78.2%, p < 0.001), diabetes mellitus (28.5 vs 43.1%, p < 0.001), dyslipidemia (62.2 vs 64.3%, p = 0.023), coronary artery disease (19.6 vs 25.6%, p < 0.001), neoplasia (4.4 vs 7.0%, p < 0.001), peripheral arterial disease (5.2 vs 15.8%, p < 0.001) and chronic kidney disease (4.6 vs 10.0%, p < 0.001). Logistic regression revealed that body mass index, diabetes, arterial hypertension, neoplasia and dyslipidemia were not predictors of HF during the hospitalization for ACS. Nevertheless, female gender (odds ratio (OR) 1.37, p < 0.001, confidence interval (CI) 1.22-1.54), chronic kidney disease (OR 1.59, p < 0.001, CI 1.33-1.90) and peripheral arterial disease (OR 1.54, p < 0.001, CI 1.27-1.86) were predictors of new onset of HF during hospitalization for ACS. Curiously, smoking seems to have a protective effect (OR 0.68, p < 0.001, CI 0.59-0.78) in new onset HF in ACS patients. Conclusions Chronic kidney disease and peripheral arterial disease were predictors of new onset of HF in during hospitalization for ACS.

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Cardiovascular risk factors as predictors of new onset atrial fibrillation during hospitalization for Acute Coronary Syndromes

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.001 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

H Santos ◽

M Santos ◽

I Almeida ◽

H Miranda ◽

C Sa ◽

...

Keyword(s):

Coronary Artery Disease ◽

Body Mass Index ◽

Chronic Kidney Disease ◽

Coronary Artery ◽

Kidney Disease ◽

Arterial Hypertension ◽

Arterial Disease ◽

Artery Disease ◽

Peripheral Arterial ◽

New Onset

Abstract Funding Acknowledgements Type of funding sources: None. OnBehalf Portuguese Registry of Acute Coronary Syndromes Background Cardiovascular risk factors (CVRF) are a growing health problem in developed countries, being directly associated with acute coronary syndrome (ACS) occurrence and atrial fibrillation (AF). Nevertheless, new onset of AF in context of ACS is a clinical problem with prognostic and therapeutic implications. Objective Evaluate the impact of the CVRF in new onset AF during the hospitalization for ACS. Methods Multicenter retrospective study, based on the Portuguese Registry of ACS between 1/10/2010-4/09/2019. Patients were divided in two groups: A – without new onset of AF during the hospitalization for ACS and B – with new onset of AF during the hospitalization for ACS. CVFR was defined by body mass index, diabetes, arterial hypertension, smoking, coronary artery disease, neoplasia, dyslipidemia, chronic kidney disease and peripheral arterial disease. Logistic regression was performed to assess predictors of new onset AF in these patients. Results 14037 patients were included, 637 in group B (4.8%). Both groups were similar regarding diabetes mellitus (p = 0.116), coronary artery disease (p = 0.264) and neoplasia (p = 0.327). Curiously the group A exhibited higher body mass index (27.5 ± 4.3 vs 27.2 ± 4.4, p < 0.001), smokers (28.1 vs 18.5%, p < 0.001) and dyslipidemia (62.8 vs 56.7%, p < 0.001). On the other hand, group B presented more females (26.4 vs 35.0%, p < 0.001), arterial hypertension (70.0 vs 74.9%, p = 0.002), peripheral arterial disease (5.4 vs 8.4%, p < 0.001) and chronic kidney disease (6.7 vs 9.5%, p < 0.001). Logistic regression revealed that body mass index, smoker status, diabetes, dyslipidemia, coronary artery disease, neoplasia, chronic kidney disease and peripheral arterial disease were not predictors of AF during the hospitalization for ACS. Nonetheless, female gender (odds ratio (OR) 1.23, p = 0.025, confidence interval (CI) 1.03-1.47), obesity (OR 1.39, p = 0.004, CI 1.11-1.74) and arterial hypertension (OR 1.22, p = 0.049, CI 1.01-1.50) were predictors of new onset of AF during hospitalization for ACS. Conclusions: Female gender, obesity and arterial hypertension were predictors of new onset of AF in during hospitalization for ACS.

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Cardiovascular risk factors as predictors of completed atrioventricular block during hospitalization for Acute Coronary Syndromes

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.081 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

H Santos ◽

M Santos ◽

H Miranda ◽

I Almeida ◽

C Sa ◽

...

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

Body Mass Index ◽

Chronic Kidney Disease ◽

Acute Coronary Syndromes ◽

Arterial Disease ◽

Coronary Syndromes ◽

Artery Disease ◽

Group B ◽

Peripheral Arterial

Abstract Funding Acknowledgements Type of funding sources: None. OnBehalf Portuguese Registry of Acute Coronary Syndromes Background The presence of cardiovascular risk factors (CVRF) are directly related to acute coronary syndrome (ACS) occurrence. ACS is a major health problem with multiple complications. Completed atrioventricular block (CAVB) in context of ACS can impact the patient’s prognosis, and is not clarified if its presence can be predicted only by CVFR. Objective Evaluate the impact of the CVRF in CAVB during the hospitalization for ACS. Methods Multicenter retrospective study, based on the Portuguese Registry of ACS between 1/10/2010-4/09/2019. Patients were divided in two groups: A – without CAVB during the hospitalization for ACS and B – with CAVB during the hospitalization for ACS. CVFR was defined by body mass index, diabetes, arterial hypertension, smoking, coronary artery disease, neoplasia, dyslipidemia, chronic kidney disease and peripheral arterial disease. Logistic regression was performed to assess predictors of CAVB in these patients. Results 14031 patients were included, 401 in group B (2.9%). Both groups were similar regarding smoking status (p = 0.920), arterial hypertension (p = 0.928), diabetes mellitus (p = 0.249), peripheral arterial disease (p = 0.352) and chronic kidney disease (p = 0.783). Interestingly the group A exhibited higher body mass index (27.4 ± 4.3 vs 26.9 ± 4.5, p < 0.001), dyslipidemia (62.8 vs 53.6%, p < 0.001) and coronary artery disease (20.7 vs 15.0%, p = 0.001). On the other hand, group B presented more females (26.7 vs 31.5%, p = 0.012), mean age (66 ± 13 vs 71 ± 13, p < 0.001) and neoplasia (4.8 vs 7.1%, p = 0.012). Logistic regression revealed that any of the CVRF were a predictor of CAVB during the hospitalization for ACS. Just, age (odds ratio 1.48, p < 0.001, confidence interval 1.16-1.88) has been a predictor of CAVB during hospitalization for ACS. Conclusions Any CVFR was a predictor of CAVB in context of ACS. Age was a predictor of CAVB during hospitalization for ACS.

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The influence of the obesity paradox and chronic kidney disease on long-term survival in a Japanese cohort with peripheral arterial disease

Journal of Vascular Surgery ◽

10.1016/j.jvs.2010.02.008 ◽

2010 ◽

Vol 52 (1) ◽

pp. 110-117 ◽

Cited By ~ 50

Author(s):

Hisao Kumakura ◽

Hiroyoshi Kanai ◽

Masahiro Aizaki ◽

Kito Mitsui ◽

Yoshihiro Araki ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Peripheral Arterial Disease ◽

Obesity Paradox ◽

Arterial Disease ◽

Term Survival ◽

Long Term Survival ◽

Japanese Cohort ◽

Peripheral Arterial

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Epidemiology and Diagnosis of Peripheral Arterial Disease in Patients With Chronic Kidney Disease

Advances in Chronic Kidney Disease ◽

10.1053/j.ackd.2008.07.007 ◽

2008 ◽

Vol 15 (4) ◽

pp. 378-383 ◽

Cited By ~ 19

Author(s):

Joachim H. Ix ◽

Michael H. Criqui

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Peripheral Arterial Disease ◽

Arterial Disease ◽

Peripheral Arterial

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Traditional and non-traditional risk factors for incident peripheral arterial disease among patients with chronic kidney disease

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfv418 ◽

2015 ◽

Vol 31 (7) ◽

pp. 1145-1151 ◽

Cited By ~ 23

Author(s):

Jing Chen ◽

Emile R. Mohler ◽

Dawei Xie ◽

Michael Shlipak ◽

Raymond R. Townsend ◽

...

Keyword(s):

Risk Factors ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Peripheral Arterial Disease ◽

Arterial Disease ◽

Traditional Risk Factors ◽

Peripheral Arterial

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Vascular calcification score on plain radiographs of the feet as a predictor of peripheral arterial disease in patients with chronic kidney disease

International Urology and Nephrology ◽

10.1007/s11255-009-9697-8 ◽

2009 ◽

Vol 42 (3) ◽

pp. 773-780 ◽

Cited By ~ 18

Author(s):

Won Suk An ◽

Young Ki Son ◽

Seong-Eun Kim ◽

Ki-Hyun Kim ◽

Seong Kuk Yoon ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Peripheral Arterial Disease ◽

Vascular Calcification ◽

Arterial Disease ◽

Plain Radiographs ◽

Calcification Score ◽

Peripheral Arterial

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Abstract 20579: Chronic Kidney Disease is Associated With Increased Mortality and Major Adverse Cardiovascular Events in Patients With Peripheral Arterial Disease

Circulation ◽

10.1161/circ.130.suppl_2.20579 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Gregory G Westin ◽

Ehrin J Armstrong ◽

Debbie C Chen ◽

John R Laird

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Peripheral Arterial Disease ◽

Cardiovascular Events ◽

Cox Model ◽

Univariate Analysis ◽

Arterial Disease ◽

Major Adverse Cardiovascular Events ◽

Ckd Stage ◽

Peripheral Arterial

Introduction: Chronic kidney disease (CKD) is common in patients with peripheral arterial disease (PAD), but patients with severe CKD have been excluded from many trials and no objective performance goals exist for patients with PAD and CKD. We sought to analyze the association between severity of CKD and cardiovascular and limb-related outcomes among patients with PAD. Methods: We reviewed records of all patients at our institution who underwent lower extremity angiography between 2006 and 2013. We analyzed outcomes including mortality, major adverse cardiovascular event (MACE) rate, and major adverse limb event (MALE) rate according to clinical stage of CKD, determined by calculating each patient’s glomerular filtration rate using the Cockcroft-Gault equation. We used Cox proportional hazard modeling to account for covariates, along with Bonferroni correction for multiple comparisons. Results: Of 773 patients, 45% had CKD stage 3-5. The patients had a median age of 67, were 58% male, 51% diabetic, and 57% presented with critical limb ischemia (CLI). During a median follow-up time of 3.2 years, patients with higher stages of CKD had an increased rate of death (Figure 1, p<0.001). CKD stages 4 and 5 were significant predictors of mortality in a multivariate model (HR 3.2 and 2.4 vs. CKD 1, P<0.001 and P<0.01, respectively). An analysis of MACE by CKD stage demonstrated similar results (CKD 4 HR 2.2, p<0.01; CKD 5 HR 2.0, p<0.01). CKD stage also predicted MALE in a univariate analysis (p<0.01), driven by increased limb events among patients with CKD stage 5 (p<0.01). However, CKD stage did not demonstrate a significantly increased hazard of MALE in a multivariate Cox model. Conclusions: Patients with PAD who also have CKD have increased rates of adverse outcomes. This relationship seems to be more robust for major cardiovascular events and overall mortality than for major limb events. Future studies should investigate how management of PAD should differ for patients with CKD.

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