Burden of illness among patients at high risk versus low risk for major cardiovascular events

2010 ◽  
Vol 13 (3) ◽  
pp. 438-446
Author(s):  
Carolyn Harley ◽  
Stephen D. Sander ◽  
Victoria Zarotsky ◽  
Feng Cao ◽  
Hemal Shah
Keyword(s):  
High Risk ◽  
Cardiovascular Events ◽  
Burden Of Illness ◽  
Low Risk ◽  
Major Cardiovascular Events

scholarly journals PCV47 BURDEN OF ILLNESS AMONG PATIENTS AT HIGH RISK FOR MAJOR CARDIOVASCULAR EVENTS

2007 ◽  
Vol 10 (3) ◽  
pp. A50-A51
Author(s):  
C Harley ◽  
C Zema ◽  
F Cao ◽  
X Ye ◽  
H Shah
Keyword(s):  
High Risk ◽  
Cardiovascular Events ◽  
Burden Of Illness ◽  
Major Cardiovascular Events

P3609Temporal trends of the management and outcomes of patients after myocardial infarction according to the risk for recurrent cardiovascular events

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Grinberg ◽  
T Bental ◽  
Y Hammer ◽  
A R Assali ◽  
H Vaknin-Assa ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
High Risk ◽  
Cardiovascular Events ◽  
Risk Group ◽  
Temporal Trends ◽  
High Risk Group ◽  
Low Risk ◽  
Intermediate Risk ◽  
High Risk Patients ◽  
Risk Patients

Abstract Background Following Myocardial Infarction (MI), patients are at increased risk for recurrent cardiovascular events, particularly during the immediate period. Yet some patients are at higher risk than others, owing to their clinical characteristics and comorbidities, these high-risk patients are less often treated with guideline-recommended therapies. Aim To examine temporal trends in treatment and outcomes of patients with MI according to the TIMI risk score for secondary prevention (TRS2°P), a recently validated risk stratification tool. Methods A retrospective cohort study of patients with an acute MI, who underwent percutaneous coronary intervention and were discharged alive between 2004–2016. Temporal trends were examined in the early (2004–2010) and late (2011–2016) time-periods. Patients were stratified by the TRS2°P to a low (≤1), intermediate (2) or high-risk group (≥3). Clinical outcomes included 30-day MACE (death, MI, target vessel revascularization, coronary artery bypass grafting, unstable angina or stroke) and 1-year mortality. Results Among 4921 patients, 31% were low-risk, 27% intermediate-risk and 42% high-risk. Compared to low and intermediate-risk patients, high-risk patients were older, more commonly female, and had more comorbidities such as hypertension, diabetes, peripheral vascular disease, and chronic kidney disease. They presented more often with non ST elevation MI and 3-vessel disease. High-risk patients were less likely to receive drug eluting stents and potent anti-platelet drugs, among other guideline-recommended therapies. Evidently, they experienced higher 30-day MACE (8.1% vs. 3.9% and 2.1% in intermediate and low-risk, respectively, P<0.001) and 1-year mortality (10.4% vs. 3.9% and 1.1% in intermediate and low-risk, respectively, P<0.001). During time, comparing the early to the late-period, the use of potent antiplatelets and statins increased among the entire cohort (P<0.001). However, only the high-risk group demonstrated a significantly lower 30-day MACE (P=0.001). During time, there were no differences in 1-year mortality rate among all risk categories. Temporal trends in 30-day MACE by TRS2°P Conclusion Despite a better application of guideline-recommended therapies, high-risk patients after MI are still relatively undertreated. Nevertheless, they demonstrated the most notable improvement in outcomes over time.

scholarly journals TheENPP1Q121 Variant Predicts Major Cardiovascular Events in High-Risk Individuals

Diabetes ◽  
2011 ◽  
Vol 60 (3) ◽  
pp. 1000-1007 ◽  
Author(s):  
Simonetta Bacci ◽  
Stefano Rizza ◽  
Sabrina Prudente ◽  
Belinda Spoto ◽  
Christine Powers ◽  
...  
Keyword(s):  
High Risk ◽  
Cardiovascular Events ◽  
Major Cardiovascular Events

Abstract 2985: Impact of PCI in Patients with Recent Onset Severe Angina or Stabilized ACS Treated with Optimal Medical Therapy: a COURAGE Trial High Risk Subset

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
David J Maron ◽  
John A Spertus ◽  
G.B. John Mancini ◽  
Pamela M Hartigan ◽  
Marcin Dada ◽  
...  
Keyword(s):  
High Risk ◽  
Medical Therapy ◽  
Cardiovascular Events ◽  
Optimal Medical Therapy ◽  
Recent Onset ◽  
High Risk Patients ◽  
Major Cardiovascular Events ◽  
Significant Difference ◽  
Risk Patients ◽  
Class Iv

Background: The COURAGE trial randomized 2,287 patients with stable coronary artery disease (CAD) to optimal medical therapy (OMT) with or without percutaneous coronary intervention (PCI). Eligibility criteria allowed entry of patients with recent onset, severe angina and recently stabilized acute coronary syndromes (ACS). We hypothesized that patients with recent onset, severe angina or recently stabilized ACS had higher risk for death or MI, and that this risk was reduced by PCI. Methods: High risk was defined as Canadian Cardiovascular Society class III angina with first onset of symptoms ≤ 2 months prior to enrollment, recently stabilized class IV angina, or recently stabilized ACS not treated with PCI. Persistent class IV angina patients were excluded. Patients were permitted to undergo revascularization during the trial as clinically indicated for unremitting angina or ACS. The chi square test was used for between group comparisons. Results: At baseline, 12% of COURAGE patients were classified as high risk. Within each treatment arm, high risk patients were more likely to suffer death or MI than non-high risk patients (OMT group, 26% vs. 17%, P=0.006; PCI group 24% vs. 18%, P=0.06). There was no significant difference between treatment arms for major cardiovascular events in patients at high risk (see Table ). As observed in the entire COURAGE cohort, revascularization was more frequent in high risk patients randomized to OMT compared with PCI (42% vs. 30%, P=0.04). Outcomes in High Risk Patients Randomized to OMT Alone or OMT + PCI Conclusions: The addition of PCI to OMT as an initial management strategy did not reduce death, MI or other major cardiovascular events in this high risk subset of COURAGE patients with recent onset severe angina or stabilized ACS.

Impact of Life's Simple 7 on the incidence of major cardiovascular events in high-risk Spanish adults in the PREDIMED study cohort

2020 ◽  
Vol 73 (3) ◽  
pp. 205-211
Author(s):  
Javier Díez-Espino ◽  
Pilar Buil-Cosiales ◽  
Nancy Babio ◽  
Estefanía Toledo ◽  
Dolores Corella ◽  
...  
Keyword(s):  
High Risk ◽  
Cardiovascular Events ◽  
Study Cohort ◽  
Major Cardiovascular Events ◽  
Life’S Simple 7 ◽  
Life's Simple 7 ◽  
Predimed Study

scholarly journals P193 Echocardiographic prognosis score and stratification of the risk of major cardiovascular events after acute coronary syndrome

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
F Menzou ◽  
N Laraba ◽  
M Ait Ali ◽  
M Krim
Keyword(s):  
Acute Coronary Syndrome ◽  
High Risk ◽  
Cardiovascular Event ◽  
Cardiovascular Events ◽  
Major Cardiovascular Event ◽  
Aggressive Approach ◽  
Clinical Prognosis ◽  
Coronary Syndrome ◽  
Major Cardiovascular Events ◽  
Echocardiographic Parameters

Abstract Introduction The stratification of the risk of a major cardiovascular event after an acute coronary syndrome by doppler echocardiography provides prognostic support to the different clinical models and allows a non-invasive evaluation of the risk, independent of comorbidities. The echo-score provides a better definition of the categories of high-risk and intermediate patients for whom a more aggressive approach improves outcomes. Purpose The aim of our study is to identify the echocardiographic parameters predictive of major cardiovascular events in the acute phase and after six months of follow-up of an acute coronary syndrome Methods To identify the echocardiographic parameters associated with major cardiovascular event, we recruited 302 patients in intensive care unit of cardiology for acute coronary syndrome consecutively on admission. Patients were assessed by clinical risk scores (GRACE, TIMI, CRUSADE) and resting echocardiography, Results We have 181 patients with major cardiovascular event. After studying the survival curves, univariate and multivariate analysis, acute coronary events echoscore (HR 1,95 ; p &lt; 0,0001), has four echocardiographic variables (VG-Simpson - biplane ejection fraction, VD-surface - Simpson shortening fraction, M-strain longitudinal total deformation and pulmonary ultrasonic comet). Its discrimination capacity (AUC= 0,85) greater than that of the scores clinical prognosis, (GRACE; AUC = 0,72, TIMI; AUC = 0,71, HR 1,33; p &lt; 0,0001) and (CRUSADE; AUC = 0,76; HR 1,03; p = 0,005) Conclusion The developed echocardiographic model could prove very useful in the decision-making process and optimization of the therapeutic strategy in some high-risk patients with acute coronary syndromes following an invasive strategy. It is appropriate for expert interpretation, yet relatively simple because it contains only four echocardiographic variables as predictors, (score 4 points for low risk with a probability of major cardiovascular event 3.4%, up to 16 points for risk high with a probability of 15.1%)

Sign in / Sign up

Export Citation Format

Share Document