scholarly journals Predictors for Long-Term Prognosis after Acute Coronary Syndrome

2021 ◽  
Vol 14 (1) ◽  
pp. 31-46
Author(s):  
Krastina I. Doneva-Basheva ◽  
Damyan P. Petrov ◽  
Tatyana I. Vlaykova ◽  
Snezhana T. Tisheva
Keyword(s):  
Acute Coronary Syndrome ◽  
Regression Analysis ◽  
Systolic Function ◽  
Developed Countries ◽  
Elderly Age ◽  
Term Survival ◽  
Coronary Syndrome ◽  
Significant Difference ◽  
Grace Score

Summary Cardiovascular diseases (CVD) are the leading cause of invalidity and death in developed countries. Among them, the main cause of death is coronary artery disease. In this retrospective study, 172 patients with acute coronary syndrome (STEMI, NSTEMI, UA) are included. They had been hospitalized on an emergency basis in the Cardiology Department, Invasive Sector of Prof. Dr. St. Kirkovich Hospital in Stara Zagora, and the Cardiology Hospital -Yambol between January 2009 and February 2010. We found a significant difference in the age at acute coronary syndrome (ACS) occurrence by sex: earlier manifestation was observed in men (p=0.018). The univariant regression analysis showed that elderly age (p=0.005, OR 1.024), glomerular filtration <90 ml/h (p=0.006, OR 0.964), GRACE-score > 140 pt (p<0.001, OR 1.045), HF (Killip class ≥ II) (p=0.002, OR 15.6) and EF<40% (p=0.003, OR 1) were factors for adverse prognosis in the first, fifth and ninth year. Only GRACE-score was an independent predictor of death obtained by multivariate regression analysis in the study (p=0.002, OR 1.052). The factors influencing long-term survival adversely after ACS are age, smoking, chronic kidney disease, previously experienced myocardial infarction, diabetes mellitus, three-vessel coronary disease, and decreased systolic function of the left ventricle, and GRACE > 140 p.

scholarly journals Can Our Blood Groups Determine Our Life Expectancy?

2021 ◽  
Author(s):  
Gülçin Şahingöz Erdal ◽  
İsmail Bıyık ◽  
Pınar Kasapoğlu ◽  
Muhammet Hulusi Satılmışoğlu ◽  
Nlgün Işıksaçan
Keyword(s):  
Acute Coronary Syndrome ◽  
Blood Group ◽  
Blood Groups ◽  
Term Survival ◽  
Coronary Syndrome ◽  
Study Results ◽  
Significant Difference ◽  
Balanced Distribution ◽  
Tertiary Hospitals

Background/aim: In this study, we aimed to investigate the relationship between long-term mortality and survival with ABO blood group in patients with acute coronary syndrome. Materials and methods: This observational study was carried out in two tertiary hospitals. 192 patients followed for 72 months due to acute coronary syndrome, showing a balanced distribution for ejection fraction, additional diseases and age, were included in the study. Results: The survival rate was evaluated in 72 months follow-up. In the survival analysis according to individual blood groups; there was no statistically significant difference between the groups. When the patients were divided into two groups, there was 24.39% mortality in those with O blood group and 15.23% mortality in those without O blood group (p>0.05). Although it was not statistically significant, in patients with O blood group, an increasing tendency was observed in 72 month mortality (p>0.05). There was no association between Rh antigen and survival in this study (p=0.79). Conclusion: Although it was not able to reach statistically significance limit, a decreasing tendency in long-term survival was observed in patients with O blood group compared to those without O blood group in patients with acute coronary syndrome. The results should be confirmed by larger prospective studies.

Long Term Prognostic Utility of Matrix Metalloproteinase-9 in Patients with Acute Coronary Syndrome – A Systematic Review

2020 ◽  
Vol 21 ◽  
Author(s):  
Anamika Das ◽  
Melvin George ◽  
Durga Jha ◽  
Luxitaa Goenka
Keyword(s):  
Acute Coronary Syndrome ◽  
High Risk ◽  
Matrix Metalloproteinase ◽  
Developed Countries ◽  
Left Ventricular ◽  
Original Research ◽  
Coronary Syndrome ◽  
Potential Biomarker ◽  
Prognostic Utility

Background: Acute coronary syndrome (ACS) is the leading cause for morbidity and mortality in developed countries. Numerous groups have explored single and multiple biomarker strategies to identify diagnostic prognosticators of ACS which will improve our ability to identify high-risk individuals. Matrix metalloproteinase (MMP-9) is one potential biomarker which has been widely studied in ACS. Recent reports have showed the prognostic utility of MMP-9, but due to inconsistent results, it has not been possible to draw firm conclusions. Objective: This review aims to explore the ability of MMP-9 to predict long-term prognosis of ACS. To clarify this issue, we conducted a literature review to provide a comprehensive assessment of MMP-9 levels in ACS patients. Method: We retrieved a total of 1501 articles from PubMed and Google Scholar. After thorough scrutiny, 12 original research articles were found fulfilling the inclusion exclusion criteria. MMP-9’s ability as a biomarker of prognostication post ACS was reviewed. PRISMA guidelines were used for reporting. Result: The results revealed that MMP-9, apart from being an efficient diagnostic biomarker for ACS, helps in predicting the future risk of ACS with disease outcome. Positive correlation was found between plasma MMP-9 and left ventricular remodeling. A positive association was also found between cardiovascular death and higher MMP-9 levels. Conclusion: MMP-9 can be a potential prognostic marker for ACS and aid in identifying high risk patients for intensive management during follow -up.

scholarly journals The effect of obstructive sleep apnoea on timing of acute coronary syndrome

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M.H Muhmad Hamidi ◽  
H Sani ◽  
M.A Ibrahim ◽  
K.S Ibrahim ◽  
A.B Md Radzi ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
High Risk ◽  
Systolic Function ◽  
Strong Association ◽  
Multiple Logistic Regression Analysis ◽  
Sleep Apnoea ◽  
Neck Circumference ◽  
Coronary Syndrome ◽  
Obstructive Sleep ◽  
Significant Difference

Abstract Background and objective Acute coronary syndrome (ACS) remains the principal cause of death in Malaysia. It is estimated about 20% of ACS occurs at nighttime during sleep between 12am to 6am. Factors associated with nocturnal ACS are unknown. Acute nocturnal pathophysiological response to obstructive sleep apnea (OSA) may increase risk of nocturnal ACS. We hypothesized that OSA risk is associated with timing of ACS onset. Methodology This study included 200 patients with ACS who underwent coronary angiogram for which the time of chest pain onset was clearly identified and divided into 2 groups; nocturnal ACS (12am-5.59am) and non-nocturnal ACS (6am–11.59pm). Two validated questionnaires, STOP-BANG and Epworth Sleepiness Scale (ESS) were self-administered by subjects to determine OSA risk. All subjects timing of ACS onset, OSA risk, demography, anthropometric measurements, comorbidities and echocardiographic characteristics were analyzed. Results Acute coronary syndrome occurs nocturnally in 19% of ACS patients. The prevalence of high risk OSA individuals among ACS patients is 43%. There is significantly higher prevalence of high risk OSA individuals in nocturnal ACS group of 95% compared to 30% of high risk OSA individuals in non-nocturnal ACS group (p=0.001). Nocturnal ACS patients was significantly younger (50.1±8.7yrs, p=0.001), had higher BMI (33.9±4.3kg/m2, p=0.005), waist circumference (106.7±10.3cm, p=0.003) and larger neck circumference (44.6±3.3cm, p=0.001) compared to non-nocturnal ACS group. These groups had similar prevalence of other comorbidities for ACS and showed no significant difference between left and right ventricular systolic function. In multiple logistic regression analysis, the most significant predictors for nocturnal ACS are OSA risk, neck circumference and age. Conclusion There is a strong association between high risk OSA individuals and nocturnal ACS onset. Patient with nocturnal ACS onset should be screened for OSA and prioritized for polysomnography. OSA prevalence according to ACS onset Funding Acknowledgement Type of funding source: None

Anemia increases long-term mortality in patients undergoing conventional coronary angiography – the ECAT registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
B Balcer ◽  
I Dykun ◽  
S Hendricks ◽  
F Al-Rashid ◽  
M Totzeck ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Regression Analysis ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Conventional Coronary Angiography ◽  
Term Survival ◽  
Coronary Syndrome ◽  
Artery Disease

Abstract Background Anemia is a frequent comorbidity in patients with coronary artery disease (CAD). Besides a complemental effect on myocardial oxygen undersupply of CAD and anemia, available data suggests that it may independently impact the prognosis in CAD patients. We aimed to determine the association of anemia with long-term survival in a longitudinal registry of patients undergoing conventional coronary angiography. Methods The present analysis is based on the ECAD registry of patients undergoing conventional coronary angiography at the Department of Cardiology and Vascular Medicine at the University Clinic Essen between 2004 and 2019. For this analysis, we excluded all patients with missing hemoglobin levels at baseline admission or missing follow-up information. Anemia was defined as a hemoglobin level of &lt;13.0g/dl for male and &lt;12.0g/dl for female patients according to the world health organization's definition. Cox regression analysis was used to determine the association of anemia with morality, stratifying by clinical presentation of patients. Hazard ratio and 95% confidence interval are depicted for presence vs. absence of anemia. Results Overall, data from 28,917 patient admissions (mean age: 65.3±13.2 years, 69% male) were included in our analysis (22,570 patients without and 6,347 patients with anemia). Prevalence of anemia increased by age group (age &lt;50 years: 16.0%, age ≥80 years: 27.7%). During a mean follow-up of 3.2±3.4 years, 4,792 deaths of any cause occurred (16.6%). In patients with anemia, mortality was relevantly higher as compared to patients without anemia (13.4% vs. 28.0% for patients without and with anemia, respectively, p&lt;0.0001, figure 1). In univariate regression analysis, anemia was associated with 2.4-fold increased mortality risk (2.27–2.55, p&lt;0.0001). Effect sizes remained stable upon adjustment for traditional risk factors (2.38 [2.18–2.61], p&lt;0.0001). Mortality risk accountable to anemia was significantly higher for patients receiving coronary interventions (2.62 [2.35–2.92], p&lt;0.0001) as compared to purely diagnostic coronary angiography examinations (2.31 [2.15–2.47], p&lt;0.0001). Likewise, survival probability was slightly worse for patients with anemia in acute coronary syndrome (2.70 [2.29–3.12], p&lt;0.0001) compared to chronic coronary syndrome (2.60 [2.17–3.12], p&lt;0.0001). Interestingly, within the ACS entity, association of anemia with mortality was relevantly lower in STEMI patients (1.64 [1.10–2.44], p=0.014) as compared to NSTEMI and IAP (NSTEMI: 2.68 [2.09–3.44], p&lt;0.0001; IAP: 2.67 [2.06–3.47], p&lt;0.0001). Conclusion In this large registry of patients undergoing conventional coronary angiography, anemia was a frequent comorbidity. Anemia relevantly influences log-term survival, especially in patients receiving percutaneous coronary interventions. Our results confirm the important role of anemia for prognosis in patients with coronary artery disease, demonstrating the need for specific treatment options. Figure 1. Kaplan Meier analysis Funding Acknowledgement Type of funding source: None

Successfully Resuscitated Cardiac Arrest is Associated with Reduced In-hospital, but not Long-term Survival in Acute Coronary Syndrome

2008 ◽  
Vol 17 ◽  
pp. S108
Author(s):  
Benjamin K. Dundon ◽  
Luan T. Huynh ◽  
Stephen G. Worthley ◽  
Carolyn Astley ◽  
Ashish Soman ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Cardiac Arrest ◽  
Term Survival ◽  
Long Term Survival ◽  
Coronary Syndrome

scholarly journals Long-term survival and causes of death in patients with ST-elevation acute coronary syndrome without obstructive coronary artery disease

2017 ◽  
Vol 39 (2) ◽  
pp. 102-110 ◽  
Author(s):  
Hedvig Bille Andersson ◽  
Frants Pedersen ◽  
Thomas Engstrøm ◽  
Steffen Helqvist ◽  
Morten Kvistholm Jensen ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Causes Of Death ◽  
Obstructive Coronary Artery Disease ◽  
Term Survival ◽  
Coronary Syndrome ◽  
St Elevation ◽  
Artery Disease

scholarly journals Using the GRACE Score to Assess Long-term Risk in Patients with Non-ST Elevation Acute Coronary Syndrome

Doctor Ru ◽  
2019 ◽  
Vol 157 (2) ◽  
pp. 12-18
Author(s):  
S.A. Berns ◽  
◽  
E.A. Shmidt ◽  
A.V. Klimenkova ◽  
S.A. Tumanova ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Syndrome ◽  
St Elevation ◽  
Elevation Acute Coronary Syndrome ◽  
Grace Score

P5656Heart failure clinical phenotypes and outcomes in patients with atrial fibrillation: an analysis from the eurobservational research programme in atrial fibrillation long-term general registry

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Proietti ◽  
C Laroche ◽  
A Tello-Montoliu ◽  
R Lenarczyk ◽  
G A Dan ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Acute Coronary Syndrome ◽  
Regression Analysis ◽  
Cox Regression ◽  
Adverse Outcomes ◽  
Cox Regression Analysis ◽  
Coronary Syndrome

Abstract Introduction Heart failure (HF) is a well-known risk factor for atrial fibrillation (AF). Moreover, HF is associated with worse clinical outcomes in patients with known AF. Recently, phenotypes of HF have been redefined according to the level of ejection fraction (EF). New data are needed to understand if a differential risk for outcomes exists according to the new phenotypes' definitions. Purpose To evaluate the risk of major adverse outcomes in patients with AF and HF according to HF clinical phenotypes. Methods We performed a subgroup analysis of AF patients enrolled in the EORP-AF Long-Term General Registry with a history of HF at baseline, available EF and follow-up data. Patients were categorized as follows: i) EF<40%, i.e. HF reduced EF [HFrEF]; ii) EF 40–49%, i.e. HF mid-range EF [HFmrEF]; iii) EF ≥50%, i.e. HF preserved EF [HFpEF]. Any thromboembolic event (TE)/acute coronary syndrome (ACS)/cardiovascular (CV) death, CV death and all-cause death were recorded. Results A total of 3409 patients were included in this analysis: of these, 907 (26.6%) had HFrEF, 779 (22.9%) had HFmrEF and 1723 (50.5%) had HFpEF. An increasing proportion with CHA2DS2-VASc ≥2 was found across the three groups: 90.4% in HFrEF, 94.6% in HFmrEF and 97.3% in HFpEF (p<0.001), while lower proportions of HAS-BLED ≥3 were seen (28.0% in HFrEF, 26.3% in HFmrEF and 23.6% in HFpEF, p=0.035). At discharge patients with HFpEF were less likely treated with antiplatelet drugs (22.0%) compared to other classes and were less prescribed with vitamin K antagonists (VKA) (57.0%) and with any oral anticoagulant (OAC) (85.7%). No differences were found in terms of non-vitamin K antagonist oral anticoagulant use. At 1-year follow-up, a progressively lower rate for all study outcomes (all p<0.001), with an increasing cumulative survival, was found across the three groups, with patients with HFpEF having better survival (all p<0.0001 for Kaplan-Meier curves). After full adjustment, Cox regression analysis showed that compared to HFrEF, HFmrEF and HFpEF were associated with risk of all study outcomes (Table). Cox Regression Analysis HR (95% CI) Any TE/ACS/CV Death CV Death All-Cause Death HFmrEF 0.65 (0.49–0.86) 0.53 (0.38–0.74) 0.55 (0.41–0.74) HFpEF 0.50 (0.39–0.64) 0.42 (0.31–0.56) 0.45 (0.35–0.59) ACS = Acute Coronary Syndrome; CI = Confidence Interval; CV = Cardiovascular; EF = Ejection Fraction; HF = Heart Failure; HR = Hazard Ratio. Conclusions In this cohort of AF patients with HF, HFpEF was the most common phenotype, being associated with a profile related to an increased thromboembolic risk. Compared to HFrEF, both HFmrEF and HFpEF were associated with a lower risk of all major adverse outcomes in AF patients.

The Association between hs-CRP Levels with GRACE Score in Acute Coronary Syndrome Patients in H. Adam Malik Medan Central General Hospital

2021 ◽  
Vol 8 (8) ◽  
pp. 220-226
Author(s):  
Putri Gaby Yosephine ◽  
Refli Hasan ◽  
Rahmad Isnanta
Keyword(s):  
Acute Coronary Syndrome ◽  
General Hospital ◽  
Spearman Correlation ◽  
Correlation Test ◽  
Coronary Syndrome ◽  
Wide Range ◽  
Significant Difference ◽  
Spearman Correlation Test ◽  
Hs Crp ◽  
Grace Score

Objective: Acute coronary syndrome (ACS) describes a wide range of myocardial ischemia, which is always associated with the rupture of atherosclerotic plaques in coronary arteries. CRP has been shown to be a risk predictor of ACS. GRACE score has been associated with predicting early and late death in ACS patients. Therefore, this study aim to investigate the association between high sensitivity C-reactive protein (hs-CRP) levels with GRACE score in ACS patients. Methods: This study was a retrospective analytic study. The study population was acute coronary syndrome patients in central general hospital of H. Adam Malik, Medan city and 51 patients who met the inclusion and exclusion criteria. Data analysis was calculated using univariate and bivariate analysis. A correlation test was carried out using Spearman correlation test to determine the association between hs-CRP levels with GRACE score in ACS patients. Results: There were 51 samples included in the study. There was a significant difference (p = 0.005) in the mean hs-CRP levels in UAP, NSTEMI, and STEMI subjects. In contrast, there was no significant difference in GRACE score among the three ACS diagnoses. For the association of hs-CRP levels with GRACE score in all subjects, the Spearman correlation test showed a significant correlation between hs-CRP levels with GRACE score (p < 0.001) with a correlation coefficient (r) of 0.588. Conclusion: There was a significant association between serum hs-CRP levels with GRACE score and the higher hs-CRP levels, followed by a higher GRACE score. Keywords: Acute coronary syndrome, GRACE score, hs-CRP.

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