Abstract 383: Effect of Race on Risk of Recurrent Myocardial Infarction After Index Myocardial Infarction

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Raunak Nair ◽  
Michael Johnson ◽  
Kathleen A Kravitz ◽  
Moses Anabila ◽  
Jeevanantham Rajeswaran ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
African Americans ◽  
Medical Center ◽  
White Americans ◽  
Recurrent Myocardial Infarction ◽  
Increased Risk ◽  
Artery Disease ◽  
Racial Factors ◽  
White Patients

Background: Though the prevalence of coronary artery disease is known to be highest in African Americans, it is unclear if there are any racial factors predisposing patients for a recurrent Myocardial Infarction (MI) after index MI. Methods: We reviewed 6,626 cases of MI at a single quaternary care medical center from January 1 st , 2010 to January 1 st , 2017 (29% STEMI, 71% NSTEMI), and we identified all cases of recurrent MI within 90 days of discharge after index MI. The patients were categorized according to their corresponding races into White Americans, African Americans, and Others. Result: Out of the 6626 initial cases of MI, 72% were white patients, 25% were African Americans and 3% belonged to other races. A total of 2051 patients were readmitted within 90 days of index admission, of which 168 patients were readmitted with an MI. Only 2.1% of White patients developed a recurrent MI whereas 4% of African Americans were readmitted with a recurrent MI (P=0.003). Conclusion: We observed that African Americans were more likely to be readmitted with a recurrent MI than White Americans. Understanding the reasons for this increased risk in MI can translate into improved care for African Americans.

Abstract 246: Effect of Racial Factors on Timing of Readmissions After Myocardial Infarction

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Raunak Nair ◽  
Michael Johnson ◽  
Kathleen A Kravitz ◽  
Moses Anabila ◽  
Jeevanantham Rajeswaran ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
African Americans ◽  
Medical Center ◽  
Early Time ◽  
Late Time ◽  
White Americans ◽  
Time Period ◽  
Racial Factors ◽  
Early Time Period ◽  
White Patients

Background: Readmissions following acute myocardial infarction (MI) are associated with increased cost, healthcare utilization, and morbidity. The purpose of this study was to assess racial factors in influencing time for readmission after being admitted with myocardial infarction. Methods: We reviewed 6,626 cases of MI at a single quaternary care medical center from January 1 st , 2010 to January 1 st , 2017 (29% STEMI, 71% NSTEMI), and we identified all readmissions within 90 days after index MI. The patients were categorized according to their race into White Americans (72%), African Americans (25%) and others (3%). Readmissions were stratified into early (0-30 days) and late (31-90 days) time periods depending on the timing of readmission and these readmissions were also separated according to their corresponding race into White Americans (62%), African Americans (35%) and others (3%). Since White Americans and African Americans contributed to the bulk of our patient population, we analyzed the difference between these two groups. Results: There were a total of 2051 readmissions within 90 days after index MI. Overall, 50% of readmissions were in the early time period and 50% in the late period (after 30 days). 46% of African Americans were readmitted in the early time period compared to 52% of white patients whereas 54% of African Americans were readmitted in the late time period compared to 48% of white patients (P=0.0037). Conclusions: The temporal pattern of readmissions after myocardial infarction differed between Whites and African Americans. These findings may have implications regarding the development of readmission reduction strategies.

scholarly journals Ten-year cardiovascular risk in diabetes patients without of coronary artery disease – a Danish cohort study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K.K.W Olesen ◽  
M Madsen ◽  
C Gyldenkerne ◽  
P.G Thrane ◽  
T Thim ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Ischemic Stroke ◽  
Cardiovascular Risk ◽  
General Population ◽  
Funding Source ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Artery Disease ◽  
Diabetes Patients

Abstract Background Patients with diabetes without obstructive coronary artery disease (CAD) by coronary angiography (CAG) have a risk of myocardial infarction (MI) similar to that of non-diabetes patients without CAD. Their cardiovascular risk compared to the general population is unknown. Purpose We examined the 10-year risks of myocardial infarction (MI), ischemic stroke, and death in diabetes patients without CAD after CAG compared to the general population. Methods We included all diabetes patients without obstructive CAD examined by CAG from 2003–2016 in Western Denmark and an age and sex matched comparison group, sampled from the general population in Western Denmark without previous history of coronary heart disease. Outcomes were MI, ischemic stroke, and death. The 10-year cumulative incidences were estimated. Adjusted hazard ratios (HRs) were estimated by stratified Cox regression using the general population as the reference group. Results We identified 5,760 diabetes patients without obstructive CAD and 29,139 individuals from the general population. Median follow-up was 7 years with 25% of participants followed for up to 10 years. Diabetes patients without obstructive CAD had an almost similar 10-year risk of MI (3.2% vs 2.9%, adjusted HR 0.91, 95% CI 0.70–1.17, Figure) compared to the general population cohort. Diabetes patients had an increased risk of ischemic stroke (5.2% vs 2.2%, adjusted HR 1.88, 95% CI 1.48–2.39), and death (29.7% vs 17.9%, adjusted HR 1.41, 95% CI 1.29–1.54). The duration of diabetes was associated with increased cardiovascular risk. Conclusions Absence of obstructive CAD by CAG in patients with diabetes ensures a low MI risk similar to the general population, but diabetes patients still have an increased risk of ischemic stroke and all-cause death despite absence of CAD. Figure 1 Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): Department of Cardiology, Aarhus University Hospital

Abstract 13804: Clinical Profile and Outcomes of Myocardial Infarction With Non-obstructive Coronary Arteries in Older Adults

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ara H Rostomian ◽  
Derek Q Phan ◽  
Mingsum Lee ◽  
Ray X Zadegan
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Los Angeles ◽  
Coronary Arteries ◽  
Medical Center ◽  
Invasive Coronary Angiography ◽  
Obstructive Coronary Artery Disease ◽  
Kaiser Permanente ◽  
Artery Disease

Introduction: Myocardial Infarction with non-obstructive coronary artery disease (MINOCA) is found in 5%-6% of patients with acute myocardial infarction (AMI). As such, the diagnosis and management of AMI patients with non-obstructive coronary artery disease (NOCAD) poses a challenge as compared to patients with MI with coronary artery disease (MICAD). Hypothesis: To evaluate the characteristics and outcomes of MINOCA in older patients as compared with MICAD patients, with and without revascularization. Methods: This was a retrospective observational study of patients ≥80 years old who underwent invasive coronary angiography (ICA) for AMI between 2009-2019 at Kaiser Permanente Los Angeles Medical Center. MINOCA was defied as <50% stenosis of coronary arteries on angiography with a troponin level ≥0.05 ng/ml. Patients with MINOCA vs MICAD were compared. Multivariate logistic regression was used to identify independent predictors of MINOCA and Kaplan-Meier survival analysis was used to analyze all-cause mortality between cohorts. Results: A total of 259 patients with MINOCA (mean ± SD age 83.8±2.7 years, 68% female) and 687 patients with MICAD (84.7±3.4 years, 40% female) were analyzed. Younger age (odds ratio [OR]=1.11; 95% confidence interval [CI]=1.05-1.18), female sex (OR=3.14; CI=2.20-4.48), black race (OR=2.53; CI=1.61-3.98), no history of prior stroke (OR=1.56; CI=1.06-2.33), atrial fibrillation or flutter (OR=2.04; CI:1.38-3.02), lower troponin levels (OR=1.08; CI:1.03-1.11), and lower triglyceride levels per 10 mg/dl increments (OR=1.06; CI:1.03-1.11) increased the odds of having MINCOA as compared to MICAD. At median follow-up of 2.4 years, MINOCA was associated with a lower rate of death (44.8% vs 55.2%, p<0.01) compared to un-revascularized MICAD, but no difference (31.3% vs 40.4%, p=0.68) when compared to re-vascularized MICAD. Conclusions: Patients age ≥80 years with MINOCA have fewer traditional risk factors compared to their counterparts with MICAD and fewer deaths compared to un-revascularized MICAD, but similar mortality compared to revascularized MICAD

scholarly journals Association between Polymorphisms of Antioxidant Gene (MnSOD, CAT, and GPx1) and Risk of Coronary Artery Disease

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Hseng-Long Yeh ◽  
Li-Tang Kuo ◽  
Fung-Chang Sung ◽  
Chih-Ching Yeh
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Manganese Superoxide Dismutase ◽  
Medical Center ◽  
Stress Test ◽  
Genetic Effect ◽  
Multivariate Logistic Regression Model ◽  
Increased Risk ◽  
Artery Disease ◽  
Cad Risk

Objective. Reactive oxygen species (ROS) been cited as one of the major causes of atherosclerosis and coronary artery disease which are possible agents inducing DNA damage. Manganese superoxide dismutase (MnSOD), catalase (CAT), and glutathione peroxidase-1 (GPx1) have evolved to address primary defense against free radical mediated damage in mitochondria. The aim of this study was to delineate the association ofMnSOD,CAT, andGPx1polymorphisms and risk of CAD in Taiwan.Methods. We conducted a case-control study with 657 participants recruited at a medical center. All subjects were evaluated by noninvasive stress test and then quantitative coronary angiography to confirm the diagnosis of CAD. 447 CAD cases were defined as >50% stenosis of coronary artery and 210 controls were stenosed below 50%. Polymorphisms ofMnSOD(Val16Ala),CAT(C-262T), andGPx1(Pro198Leu) genes were determined by polymerase chain reaction methods. Multivariate logistic regression model was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs).Results. TheMnSODVal/Ala+Ala/Ala genotype was significantly associated with an increased risk of CAD compared to the Val/Val genotype (OR = 1.86, 95% CI = 1.15-3.01). This polymorphism was also associated with the severity of CAD of single and two vessel diseases. The corresponding ORs were 2.31 (95% CI = 1.32-4.03) and 1.92 (95% CI = 1.02-3.61), respectively. Among cigarette smokers, the harmful genetic effect ofMnSODAla allele on CAD risk was much higher (OR = 2.23, 95% CI = 1.02-4.88). However, the interaction betweenMnSODgenotype and cigarette smoking on CAD risk was not significant. No significant association betweenCATandGPx1polymorphisms and CAD risk was observed.Conclusion. Our results suggest thatMnSODpolymorphism is an independent risk factor for susceptibility to CAD in the Chinese population.

Abstract P380: Coronary Artery Disease Extent is Predictive of Heart Failure Incidence After Myocardial Infarction

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Yariv Gerber ◽  
Susan A Weston ◽  
Maurice E Sarano ◽  
Sheila M Manemann ◽  
Alanna M Chamberlain ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Proportional Hazards ◽  
Incidence Rates ◽  
Cox Proportional Hazards ◽  
Disease Extent ◽  
Increased Risk ◽  
Artery Disease

Background: Little is known about the association between coronary artery disease (CAD) and the risk of heart failure (HF) after myocardial infarction (MI), and whether it differs by reduced (HFrEF) or preserved (HFpEF) ejection fraction (EF) has yet to be determined. Subjects and Methods: Olmsted County, Minnesota residents (n=1,924; mean age, 64 years; 66% male) with first MI diagnosed in 1990-2010 and no prior HF were followed through 2013. Framingham Heart Study criteria were used to define HF, which was further classified according to EF (applying a 50% cutoff). The extent of angiographic CAD was defined at index MI according to the number of major epicardial coronary arteries with ≥50% lumen diameter obstruction. Fine & Gray and Cox proportional hazards regression models were used to assess the association of CAD categories with incidence of HF, and multiple imputation methodology was applied to account for the 19% with missing EF data. Results: During a mean (SD) follow-up of 6.7 (5.9) years, 594 patients developed HF. Adjusted for age and sex, with death considered a competing risk, the cumulative incidence rates of HF among patients with 1- (n=581), 2- (n=622), and 3-vessel disease (n=721) were 11.2%, 14.6% and 20.5% at 30 days; and 18.1%, 22.3% and 29.4% at 5 years after MI, respectively. The increased risk of HF with greater number of occluded vessels was only modestly attenuated after further adjustment for patient and MI characteristics, and did not differ materially by EF (Table). Conclusions: The extent of angiographic CAD expressed by the number of diseased vessels is independently associated with HF incidence after MI. The association is evident promptly after MI and applies to both HFrEF and HFpEF.

scholarly journals Comparative Study between Diabetic and non- Diabetic Patients Regarding Prevalence of Coronary Artery Disease and Plaque Composition by Multi-detector CT Coronary Angiography

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
H A Morsy ◽  
L A Habib ◽  
E H Abdeldayem ◽  
A I Sayed
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Diabetic Group ◽  
Diabetic Patients ◽  
Increased Risk ◽  
Artery Disease ◽  
Msct Angiography

Abstract Diabetes is known to be a major cardiovascular risk factor associated with significantly increased morbidity and mortality and particularly increased risk of major cardiac events especially myocardial infarction as a manifestation of highly incident coronary artery disease (CAD).This can lead to decreased life expectation and life quality. Major cause for myocardial infarction is plaque rupture. Prevalence of obstructive and non-obstructive plaques is increased in diabetic patients. Background and Objectives The prevalence of coronary heart disease in diabetic patients compared to non- diabetics and evaluating the composition of the plaque in diseased individuals in both groups by usage of multislice computed tomography (MSCT) angiography . Subjects and Methods A total of 80 consecutive MSCT angiography examinations were performed between August 2017 and June 2018. Of these, the patients were evaluated for the presence and type of atherosclerotic plaque and severity of luminal narrowing. Results Eighty (40 in the diabetic group and 40 in the non-diabetic group) patients underwent MSCT angiography with DM prevalence of 0.212 (95% Cl for AOR 0.056 -1.896). Among them, 20 patients (50 %) in the diabetic group and 14 patients (35 %) in the non-diabetic group had +ve coronary heart disease, 33.3 % had significant and moderately significant coronary narrowing on diabetic group and 31.3 % in non-diabetic group on MSCT angiography. Diabetic patients had more soft plaque compared with non-diabetic patients. Conclusion DM is not an independent factor for the disease occurrence in coronary artery disease but is a dependent factor in the association of other risk factors such as smoking ,hypertension and dyslipidemia.

ID: 35: ASSOCIATION BETWEEN HELICOBACTER PYLORI INFECTION WITH CORONARY ARTERY DISEASE AND ACUTE MYOCARDIAL INFARCTION: A RETROSPECTIVE CHART ANALYSIS

2016 ◽  
Vol 64 (4) ◽  
pp. 940-941
Author(s):  
N Vyas ◽  
H Alkhawam ◽  
E Saker ◽  
R Sogomonian ◽  
RA Ching Companioni ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Acute Myocardial Infarction ◽  
Helicobacter Pylori ◽  
Risk Factor ◽  
Coronary Artery ◽  
Medical Center ◽  
Control Group ◽  
Igg Antibody ◽  
Artery Disease

IntroductionHelicobacter pylori (HP) infection is known to target the gastrointestinal system and is associated with extra gastrointestinal manifestations, but there is limited literature on cardiac associations. The most supported pathogenesis uses chronic inflammation as a risk factor causing atherosclerosis resulting in cardiovascular disease. Our aim is to evaluate whether there is an association between HP infection and acute myocardial infarction (AMI) and coronary artery disease (CAD).MethodWe performed a retrospective single center study at our medical center from 2005 to 2014 consisting of 1,671 patients who underwent Coronary Angiography (CA). We divided these patients into two groups based on CA reports. Patients with CAD defined as left main stenosis of ≥50% or any stenosis of ≥70% versus normal coronaries. We reviewed each patient chart to determine the prevalence of positive serum HP IgG antibody. Smoking, hypertension, dyslipidemia and obesity were also considered in each group.ResultsOf 1,671 patients, 1,237 had evidence of CAD vs 434 with normal coronary arteries. Twelve percent of CAD patients were found to have seropositive HP (SPHP) versus 1% in the control group (OR: 7.3, 95% CI: 3.5–15, p<0.0001) as depicted in figure 1. When we looked at the CAD group and compared SPHP patients to seronegative HP (SNHP) patients we found a greater amount of multiple coronary vessels disease in the SPHP group (OR: 1.4, 95% CI: 1.1–2, P=0.04). With regards to AMI, 30% of the SPHP group presented with AMI versus 10% seen in the SNHP group (OR: 4.3, 95% CI: 3–6.5, p<0.0001). In the CAD group with SPHP there was more hyperlipidemia and a higher BMI than in the CAD SNHP group (p<0.0001 and <0.0001, respectively), but there was no statistical difference between the two groups for the risk factors of smoking, hypertension and diabetes.ConclusionAccording to this study, the results showed a correlation with SPHP patients and CAD. Patients with HP seropositivity also tend to have multiple coronary artery vessel disease. In addition, our results also confirmed that there is an association between with HP infection and AMI. We hypothesize that the associated maybe secondary to inflammatory reaction associated with HP. Additional studies with larger sample groups are needed to investigate the possible role of this pathogen as a risk factor for heart disease.Abstract ID: 35 Figure 1Twelve percent of CAD patients were found to have seropositive HP (SPHP) versus 1% in the control group (OR: 7.3, 95% CI: 3.5–15, p<0.0001).

scholarly journals Q192R and L55M polymorphism in paraoxonase 1 gene in patients with coronary heart disease of different age and sex

2009 ◽  
Vol 15 (1) ◽  
pp. 97-102 ◽  
Author(s):  
G. D. Pardo Perales ◽  
A. N. Voitovich ◽  
M. A. Bogdanova ◽  
A. Y. Anisenkova ◽  
M. I. Badmaeva ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Age Differences ◽  
Paraoxonase 1 ◽  
Increased Risk ◽  
Polymorphic Variants ◽  
Artery Disease ◽  
Pon1 Polymorphisms ◽  
Sex And Age Differences ◽  
Age And Sex

Evidence for genetic polymophisms may contribute to the dependence on sex and age differences in biochemical phenotypes, clinical manifestation, severity and success in medical treatment of coronary artery disease (CAD) comes from a variety of studies. Two genetic polymorphisms, L55M and Q192R, in the human antioxidant system paraoxonase 1 gene (PON1) have been shown to be associated with increased risk of CAD. The aim of recent study was to investigate a possible association between polymorphic variants of PON1 and CAD in patients of different age and sex. The group of patients with CAD (323 men and 71 women) and the group of healthy (114 men and 84 women) randomly sampled from St Petersburg were investigated clinically, biochemically and genetically. We found out the genotype L55M and Q192R frequencies in the group of patients with CAD were different depending on sex and age (p = 0,057, p = 0,007). In women with CAD the frequency of 55MM genotype (ОR = 2,1311, 95 % CI 1,14-3,98) was significantly higher and the frequency of 192QR genotype (ОR = 0,59, 95 % CI 0,39-0,89) was significantly lower than in men with CAD who survived myocardial infarction (MI) under the age of 45. Our results suggest that both PON1 polymorphisms play the role in risk of CAD. Furthermore, PON1 polymorphisms act in various ways in patients of different age and sex.

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