Impact of Modifiable Cardiovascular Risk Factors on Mortality After Percutaneous Coronary Intervention

BackgroundCardiac rehabilitation programs reduce the likelihood of relapse and cardiac arrest in patients with cor-onary artery disease. The goal of this study was to compare and analyze changes in cardiovascular risk factors and physical fitness in patients who participated in short-term (ST) and long-term (LT) cardiac rehabilitation programs following coronary artery percutaneous coronary intervention (PCI). MethodsThis study included 193 men aged ≥45 years who received PCI for coronary artery occlusive disease. The participants were divided into ST program participants (3 months, 108 participants; ST group) and LT program participants (12 months, 85 participants; LT group). Blood lipids analysis, body composition, and physical fitness tests were performed to assess cardiovascular risk factors and physical fitness. Paired t-test and two-way ANOVA with repeated measures were used to investigate the effect of the intervention. ResultsBoth groups had significant improvements after cardiac rehabilitation in body fat, high-density lipoprotein cholesterol, exercise duration, heart rate (HR) at rest, double product peak, VO2 peak, 6-min walking, and sit-to-stand, compared to baseline. The LT group also had significant improvements after cardiac rehabili-tation in waist circumference (WC), total cholesterol (TC), triglyceride (TG), and HR peak. LT group had significantly improved effect than ST group in WC, TC, TG, exercise time, HR peak, and 6-min walking. ConclusionThe cardiac rehabilitation program led to improved cardiovascular risk factors and physical fitness, and the LT program was more effective than the ST program.

Download Full-text

Clinical outcomes following primary percutaneous coronary intervention for ST-elevation myocardial infarction according to sex and race

European Heart Journal Acute Cardiovascular Care ◽

10.1177/2048872617735803 ◽

2017 ◽

Vol 8 (3) ◽

pp. 264-272 ◽

Cited By ~ 6

Author(s):

Arvindra Krishnamurthy ◽

Claire Keeble ◽

Natalie Burton-Wood ◽

Kathryn Somers ◽

Michelle Anderson ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Percutaneous Coronary Intervention ◽

Cardiovascular Risk ◽

Clinical Outcomes ◽

South Asian ◽

Primary Percutaneous Coronary Intervention ◽

Multivariable Analysis ◽

Coronary Intervention ◽

Percutaneous Coronary

Background: Female sex and South Asian race have been associated with poor clinical outcomes following primary percutaneous coronary intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI) but remain understudied in large real-world series. We therefore investigated the association of sex and race with clinical outcomes following PPCI. Methods: We conducted a prospective study of all patients undergoing PPCI for STEMI between January 2009 and December 2011 at a large UK cardiac centre. Clinical characteristics and outcomes were compared according to sex and race using Chi-square test, independent samples Student’s t-test and Mann–Whitney U-test. Primary and secondary outcomes were 12-month major adverse cardiovascular events (MACEs) – defined as all-cause mortality, myocardial infarction and unplanned revascularization, analysed using Cox proportional hazard models adjusting for cardiovascular risk factors. Results: Three thousand and forty-nine patients were included. Women ( n=826) were older than men ( n=2223) (median age 69 vs. 60 years, p <0.01). Mortality (hazard ratio 1.48 (1.15–1.90)) and MACE (hazard ratio 1.40 (1.14–1.72)) were higher in women in univariable analysis. However, there were no significant sex-differences in mortality or MACE after age-stratification alone. Multivariable analysis also showed no significant differences in outcomes between sexes. South Asians ( n=297) were younger but had a higher prevalence of most risk factors than White patients ( n=2570). Mortality and MACE did not differ significantly between South Asian and White patients in univariable or multivariable analysis. Conclusion: MACE and mortality was not greater in women, or in South Asian patients following PPCI after adjustment for cardiovascular risk factors including age, which was most strongly associated with both outcomes.

Download Full-text

Impact of Psoriasis on Mortality Rate and Outcome in Myocardial Infarction

Journal of the American Heart Association ◽

10.1161/jaha.120.016956 ◽

2020 ◽

Vol 9 (18) ◽

Author(s):

Susanne Karbach ◽

Lukas Hobohm ◽

Johannes Wild ◽

Thomas Münzel ◽

Tommaso Gori ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Cardiovascular Risk ◽

Mortality Rate ◽

Cardiovascular Risk Factors ◽

Case Fatality ◽

Coronary Bypass ◽

Coronary Intervention ◽

Percutaneous Coronary ◽

The Impact

Background Psoriasis is a frequent chronic inflammatory cytokine‐mediated skin disease and was identified to be an independent risk factor for the occurrence of myocardial infarction (MI). However, data about the impact of psoriasis on mortality and other in‐hospital adverse events in the setting of MI are sparse and inconsistent. Methods and Results The nationwide German inpatient sample of the years 2005 to 2016 was used for statistical analysis. Hospitalized patients with MI were stratified for the presence of psoriasis and the impact of psoriasis on in‐hospital events was investigated. Overall, 3 307 703 patients with MI (37.6% females, 56.8% aged ≥70 years) were treated in Germany (2005–2016); among them 9028 (0.3%) were diagnosed with psoriasis. Patients with MI with psoriasis were significantly younger (68.0 [58.0–76.0] versus 73.0 [62.0–81.0] years; P <0.001) and showed significant lower in‐hospital case‐fatality rate (7.1% versus 12.4%; P <0.001), confirmed in the regression (odds ratio, 0.68; 95% CI, 0.63–0.74; P <0.001) adjusted for age, sex, and comorbidities. They more frequently revealed cardiovascular risk factors such as arterial hypertension (58.9% versus 55.0%; P <0.001), hyperlipidemia (44.4% versus 38.6%; P <0.001), smoking (14.3% versus 7.4%; P <0.001), diabetes mellitus (34.8% versus 30.4%; P <0.001) or obesity (17.9% versus 9.3%; P <0.001). While the rate of percutaneous coronary intervention (41.4 versus 42.0%; P =0.223) was comparable between both groups, coronary bypass surgery was more often performed in patients with MI with psoriasis (7.7% versus 4.7%; P <0.001). Conclusions Overall, only 0.3% of all MI cases were diagnosed with psoriasis, and patients with MI with psoriasis were in median 5 years younger than patients with MI without psoriasis. Psoriasis seems to enhance the prevalence of classical cardiovascular risk factors and might therefore explain the earlier time point for MI. Our data also showed in turn a lower in‐hospital mortality rate in patients with MI with psoriasis, presumably driven by younger age.

Download Full-text