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.

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

A 6-Month Follow-Up Study of the Relation between Apolipoprotein E Gene Polymorphism and Major Adverse Cardiovascular Events in Patients with Acute Coronary Syndrome

Cardiology ◽  
2018 ◽  
Vol 140 (3) ◽  
pp. 187-193
Author(s):  
Jinggang Xia ◽  
Shaodong Hu ◽  
Chunlin Yin ◽  
Dong Xu
Keyword(s):  
Acute Coronary Syndrome ◽  
Gene Polymorphism ◽  
Cardiovascular Events ◽  
Ldl Cholesterol ◽  
Apoe Gene ◽  
Major Adverse Cardiovascular Events ◽  
Coronary Syndrome ◽  
Apoe4 Allele ◽  
E4 Allele

Objectives: This study aimed to investigate the relation between ApoE gene polymorphisms and major adverse cardiovascular events (MACE) in patients with acute coronary syndrome (ACS) during a 6-month follow-up. Methods: From October 2016 to July 2017, 211 patients were admitted to a cardiology clinic with a diagnosis of ACS. Blood samples were obtained from all patients on the first day. The primary end point was a 6-month incidence of MACE. ApoE gene polymorphism was genotyped by real-time PCR using TaqMan® SNP Genotyping Assay. Results: The patients with the E4 allele were associated with higher low-density lipoprotein (LDL) cholesterol and total cholesterol (TC) levels compared with the patients without the E4 allele (p = 0001 and p = 0.001). The patients with the E4 allele were associated with a higher rate of MACE compared with the patients without the E4 allele (ApoE4 allele(+) 23.1% vs. ApoE4 allele(−) 9.3%; p = 0.03). Multivariable analysis suggested that E4 allele carriers showed an 85% risk increment of 6-month MACE (odds ratio 2.48, 95% confidence interval 2.37–5.95; p = 0.01). Conclusions: The trial shows that E4 allele carriers were correlated with not only higher LDL cholesterol and TC levels, but also with a higher incidence of MACE during a 6-month follow-up.

Abstract 102: Major Adverse Cardiovascular Events in U.S. Coronary Heart Disease and Acute Coronary Syndrome Patients

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
Rinat Ariely ◽  
Jennifer S Korsnes ◽  
Debanjali Mitra ◽  
Keith L Davis ◽  
Christopher Bell
Keyword(s):  
Coronary Heart Disease ◽  
Acute Coronary Syndrome ◽  
Cardiac Arrest ◽  
Heart Disease ◽  
Cardiovascular Events ◽  
Bypass Graft ◽  
Major Adverse Cardiovascular Events ◽  
Administrative Claims ◽  
Coronary Syndrome

Background: Healthcare resource utilization and costs associated with cardiovascular events among patients with coronary heart disease (CHD) and acute coronary syndrome (ACS) are needed to assess the value of treatments. Methods: A retrospective analysis of a large US administrative claims database (1/1/2006-12/31/2011) was conducted to describe episodes of major adverse cardiovascular events (MACE: hospitalization for stroke, myocardial infarction (MI), or cardiac arrest) in adults with CHD and ACS, respectively. The CHD cohort (n=245,185) had either a diagnosis of MI, a percutaneous coronary intervention (PCI) procedure or coronary artery bypass graft (CABG), or both, a CHD diagnosis and a multiple vessel coronary procedure, at a minimum. The ACS cohort (N= 75,231, not mutually exclusive with CHD) had ≥1 ACS-related hospitalization. The index date was the first observed cohort-specific disease claim and the 30-day period following the service date of the index episode or discharge date (for hospitalizations). Patients were required to have continuous health plan enrollment for 12 months +/- the index episode. HF, MI, and cardiac arrest diagnoses did not specify whether they were fatal or not. Results: Mean age in both cohorts was ~65 years and ~66% were male. The overall MI rate during the 12-month follow-up period was 15.6 and 26.4 per 1,000 person years for CHD and ACS patient, respectively. Among patients with at least one MACE, 286 CHD patients (4.8% of those with an event) and 137 ACS patients (5.5% of those with an event) experienced a second event during the 12-month follow-up period. Mean (SD) total episode-related costs per patient were $19,230 ($34,983) for CHD patients and $23,490 ($36,749) for ACS patients. Inpatient hospitalization represented the highest proportion of costs at 86.9% of CHD and 95.0% of ACS episode-related costs, while CVD-related pharmacotherapy mean costs (SD) were only $226 ($293) and $228 ($294) per patient for CHD and ACS, respectively. Conclusions: CHD and ACS are resource intensive diseases in the first year after index episode, with most costs related to hospitalizations. Outpatient cardiovascular drug costs make up a small proportion of the total costs.

scholarly journals HDL-C/apoA-I Ratio Is Associated with the Severity of Coronary Artery Stenosis in Diabetic Patients with Acute Coronary Syndrome

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Lizhe Sun ◽  
Manyun Guo ◽  
Chenbo Xu ◽  
Xiangrui Qiao ◽  
Yiming Hua ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Coronary Artery Stenosis ◽  
Artery Stenosis ◽  
Major Adverse Cardiovascular Events ◽  
Diabetic Patients ◽  
Adverse Cardiovascular Event ◽  
Coronary Syndrome ◽  
Significant Difference

Background. Emerging evidence demonstrates that the lipid metabolism in acute coronary syndrome (ACS) patients with type 2 diabetes mellitus (T2DM) differs from nondiabetic patients. However, the distinct lipid profiles and their relationships with the severity of coronary artery stenosis and prognosis in patients with T2DM remain elusive. Method and Result. This single-center, prospective cohort study enrolled 468 patients diagnosed with ACS undergoing coronary angiography, consisting of 314 non-DM and 154 DM patients. The HDL-C/apoA-I ratio was significantly higher in DM patients with a multivessel (≥3 affected vessels) lesion than a single-vessel (1-2 affected vessels) lesion. Regression analyses showed that the HDL-C/apoA-I ratio was positively correlated to the number of stenotic coronary arteries in DM patients but not non-DM patients. However, Kaplan-Meier survival analysis revealed no significant difference in the major adverse cardiovascular event rate regarding different HDL-C/apoA-I levels in DM or non-DM ACS patients at the end of the 2-year follow-up. Conclusion. A higher HDL-C/apoA-I ratio is associated with increased severity of coronary artery stenosis in DM patients with ACS but not with the rate of major adverse cardiovascular events at the end of the 2-year follow-up.

scholarly journals POS1015 ANTI-TNF DRUGS AND CARDIOVASCULAR EVENTS IN PATIENTS WITH SPONDYLOARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 775.2-776
Author(s):  
C. W. S. Chan ◽  
P. H. LI ◽  
C. S. Lau ◽  
H. Y. Chung
Keyword(s):  
Risk Factors ◽  
Psoriatic Arthritis ◽  
Cardiovascular Events ◽  
Clinical Information ◽  
Incidence Rates ◽  
Major Adverse Cardiovascular Events ◽  
Cross Sectional ◽  
Cerebrovascular Events ◽  
Cardiovascular Morbidity And Mortality

Background:Cardiovascular (CVS) diseases are the leading cause of death worldwide and patients with rheumatic diseases have an increased CVS risk including stroke and myocardial infarction (MI) (1-3). CVS risk factors and CVS events are common in SpA (4). Delineating the CVS risk and the association with medications in patients with SpA would be useful.Objectives:The objective of this study was to delineate the CVS risk and the association with medications in patients with SpA.Methods:Patients with SpA and patients with non-specific back pain (NSBP) were identified in rheumatology and orthopedics clinics respectively. Clinical information and CVS events were retrieved. Incidence rates were calculated. Association analysis was performed to determine the CVS risk of SpA and other modifiable risk factors.Results:A total of 5046 patients (SpA 2616 and NSBP 2430) were included from eight centers. Over 56 484 person-years of follow-up, 160 strokes, 84 MI and 262 major adverse cardiovascular events (MACE) were identified. Hypercholesterolemia was more prevalent in SpA (SpA 34.2%, NSBP 28.7%, P<0.01). Crude incidence rates of stroke and MI were higher in SpA patients. SpA was associated with a higher risk of MACE (HR 1.66, 95%CI 1.22-2.27, P<0.01) and cerebrovascular events (HR 1.42, 95%CI 1.01-2.00, p=0.04). The use of anti-tumor necrosis factor (TNF) drugs was associated with a reduced risk of MACE (HR 0.37, 95%CI 0.17-0.80, P=0.01) and cerebrovascular events (HR 0.21, 95%CI 0.06-0.78, P=0.02).Conclusion:SpA is an independent CVS risk factor. Anti-TNF drugs were associated with a reduced CVS risk in these patients.References:[1]Crowson CS, Liao KP, Davis JM, 3rd, Solomon DH, Matteson EL, Knutson KL, et al. Rheumatoid arthritis and cardiovascular disease. Am Heart J. 2013;166(4):622-8 e1.[2]Verhoeven F, Prati C, Demougeot C, Wendling D. Cardiovascular risk in psoriatic arthritis, a narrative review. Joint Bone Spine. 2020;87(5):413-8.[3]Liew JW, Ramiro S, Gensler LS. Cardiovascular morbidity and mortality in ankylosing spondylitis and psoriatic arthritis. Best Pract Res Clin Rheumatol. 2018;32(3):369-89.[4]Molto A, Etcheto A, van der Heijde D, Landewe R, van den Bosch F, Bautista Molano W, et al. Prevalence of comorbidities and evaluation of their screening in spondyloarthritis: results of the international cross-sectional ASAS-COMOSPA study. Ann Rheum Dis. 2016;75(6):1016-23.Disclosure of Interests:None declared.

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