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

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.

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Circulating irisin levels and coronary heart disease: association with future acute coronary syndrome and major adverse cardiovascular events

International Journal of Obesity ◽

10.1038/ijo.2014.101 ◽

2014 ◽

Vol 39 (1) ◽

pp. 156-161 ◽

Cited By ~ 50

Author(s):

K N Aronis ◽

M Moreno ◽

S A Polyzos ◽

J M Moreno-Navarrete ◽

W Ricart ◽

...

Keyword(s):

Coronary Heart Disease ◽

Acute Coronary Syndrome ◽

Heart Disease ◽

Cardiovascular Events ◽

Disease Association ◽

Major Adverse Cardiovascular Events ◽

Coronary Syndrome

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Association of Derived Neutrophil-To-Lymphocyte Ratio With Prognosis of Coronary Heart Disease After PCI

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.705862 ◽

2021 ◽

Vol 8 ◽

Author(s):

Gang-Qiong Liu ◽

Wen-Jing Zhang ◽

Jia-Hong Shangguan ◽

Xiao-Dan Zhu ◽

Wei Wang ◽

...

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Cox Regression ◽

Univariate Analysis ◽

Neutrophil To Lymphocyte Ratio ◽

Major Adverse Cardiovascular Events ◽

Lymphocyte Ratio ◽

Coronary Syndrome ◽

The Third

Aims: The present study aimed to investigate the prognostic role of derived neutrophil-to-lymphocyte ratio (dNLR) in patients with coronary heart disease (CHD) after PCI.Methods: A total of 3,561 post-PCI patients with CHD were retrospectively enrolled in the CORFCHD-ZZ study from January 2013 to December 2017. The patients (3,462) were divided into three groups according to dNLR tertiles: the first tertile (dNLR < 1.36; n = 1,139), second tertile (1.36 ≥ dNLR < 1.96; n = 1,166), and third tertile(dNLR ≥ 1.96; n = 1,157). The mean follow-up time was 37.59 ± 22.24 months. The primary endpoint was defined as mortality (including all-cause death and cardiac death), and the secondary endpoint was major adverse cardiovascular events (MACEs) and major adverse cardiovascular and cerebrovascular events (MACCEs).Results: There were 2,644 patients with acute coronary syndrome (ACS) and 838 patients with chronic coronary syndrome (CCS) in the present study. In the total population, the all-cause mortality (ACM) and cardiac mortality (CM) incidence was significantly higher in the third tertile than in the first tertile [hazard risk (HR) = 1.8 (95% CI: 1.2–2.8), p = 0.006 and HR = 2.1 (95% CI: 1.23–3.8), p = 0.009, respectively]. Multivariate Cox regression analyses suggested that compared with the patients in the first tertile than those in the third tertile, the risk of ACM was increased 1.763 times (HR = 1.763, 95% CI: 1.133–2.743, p = 0.012), and the risk of CM was increased 1.763 times (HR = 1.961, 95% CI: 1.083–3.550, p = 0.026) in the higher dNLR group during the long-term follow-up. In both ACS patients and CCS patients, there were significant differences among the three groups in the incidence of ACM in univariate analysis. We also found that the incidence of CM was significantly different among the three groups in CCS patients in both univariate analysis (HR = 3.541, 95% CI: 1.154–10.863, p = 0.027) and multivariate analysis (HR = 3.136, 95% CI: 1.015–9.690, p = 0.047).Conclusion: The present study suggested that dNLR is an independent and novel predictor of mortality in CHD patients who underwent PCI.

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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 ◽

10.1159/000491597 ◽

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.

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

Disease Markers ◽

10.1155/2020/7054596 ◽

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.

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