scholarly journals Relationship Between Different Risk Factor Patterns and Follow-Up Outcomes in Patients With ST-Segment Elevation Myocardial Infarction

2021 ◽  
Vol 8 ◽  
Author(s):  
Si Chen ◽  
Qianzi Che ◽  
Qiwen Zheng ◽  
Yan Zhang ◽  
Jia Jia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Latent Class ◽  
Normal Weight ◽  
Middle Aged ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Low Levels

Objective: Few studies have been concerned with the combined influences of the presence of multiple risk factors on follow-up outcomes in AMI patients. Our study aimed to identify risk factor patterns that may be associated with 1-year survival in male patients with ST-segment elevation myocardial infarction (STEMI).Methods: Data were from the China STEMI Care Project Phase 2 (CSCAP-2) collected between 2015 and 2018. A total of 15,675 male STEMI patients were enrolled in this study. Risk factor patterns were characterized using latent class analysis (LCA) according to seven risk factors. Associations between risk factor patterns and follow-up outcomes, including the incidence of major adverse cardiovascular and cerebrovascular events (MACCE) and all-cause death, were investigated by Cox proportional hazard regression analysis.Results: We obtained four risk factor patterns as “young and middle-aged with low levels of multimorbidity,” “middle-aged with overweight,” “middle-aged and elderly with normal weight,” and “elderly with high multimorbidity.” Four patterns had significant differences in event-free survival (P < 0.001). As compared with the patients of “young and middle-aged with low levels of multimorbidity” pattern, the risk of incidence of MACCE and all-cause death were increased in patients of “middle-aged with overweight” pattern (All-cause death: HR = 1.70, 95% CI:1.29~2.23; MACCE: HR = 1.49, 95% CI:1.29~1.72), “middle-aged and elderly with normal weight” pattern (All-cause death: HR = 3.04, 95% CI: 2.33~3.98; MACCE: HR = 1.82, 95% CI: 1.56~2.12), and “elderly with high multimorbidity” pattern (All-cause death: HR = 5.78, 95% CI: 4.49~7.42; MACCE: HR = 2.67, 95% CI: 2.31~3.10).Conclusions: By adopting a Latent Class Analysis Approach, STEMI patients can be characterized into four risk factor patterns with significantly different prognosis. The data is useful for the improvement of community health management in each specific subgroup of patients, which indicates a particular risk factor pattern.

scholarly journals MYOCARDIAL INFARCTION;

2019 ◽  
Vol 26 (01) ◽  
Author(s):  
Muhammad Farrukh Bhatti ◽  
Muhammad Abu Bakar Afzal ◽  
Ansar Latif ◽  
Zeeshan Hassan ◽  
Sharoon Shahzad
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Risk Factor ◽  
Family History ◽  
Teaching Hospital ◽  
Medical Advice ◽  
St Segment Elevation ◽  
St Segment ◽  
Males And Females

Objectives: The study was carried out to asserting the prevalence and comparative analysis of risk factor that are known to be associated with ST-segment elevation MI on the basis of genderin Emergency unit of cardiology department of Allama Iqbal Memorial Teaching Hospital, Sialkot. Study Design: Retrospective, observational study. Place and duration of Study: Department of Cardiology; Allama Iqbal Memorial Teaching Hospital, Sialkot. From 1st March 2017 till 28 Feb 2018. Patients and Methods: All patients presented in cardic emergency during specified time period at Allama Iqbal Memorial Teaching Hospital with new onset of ST segment elevation MI, having established risk factors (DM, Smoking, Family History of IHD, Obesity, Dyslipidemia) having completed follow up of 2 months were included in study. Patients were assigned in two group according to their respective gender for finding out prevalence of risk factors among them. Group-I included males while Group-II included females.Patients who didn’t completed followup, not willing to participate in study, who leave against medical advice, had CCF, CRF, CLD, LBBB, Coagulation abnormalities, stroke, any condition mimicking ST segment elevation other than STEMI were excluded from study. The data collected for variables was analyzed using SPSS v 22. Results: Three hundred and fifty (350) patients presented in cardic emergency were subjected to the study. Out of 350, 20 patients didn’t complete the follow-up of 2 months. Ten patients didn’t give consent to be included in the study while 15 patients were excluded in accordance with the exclusion criteria and 5 patients were left against medical advice. Out of 300 patients studied 233 of patients (77.7%) were males and 67(22.3%) of patients were female, with male to female ratio of 3.5:1.0. Among age group variation patients in range of 41-50 years constitute 40.3% (121 patients) of cases. Smoking as a risk factor constitute 70.4%(164 pt.) and Diabetes mellitus 62.3% (43pt.) among males and females respectively. Anterior wall MI reports to be 62.20%(145 pt.) and 82.10%(55 pt.) among males and females followed by other types of STEMI. Conclusion: Smoking is identified as an independent risk factor that can lead to STEMI in young males while Diabetes Mellitus and hypertension identified as a risk factor for progression to STEMI in females. Among non-modifiable factors male sex, old adults and family history identified as factors that can lead to STEMI.

scholarly journals Value of TIMI Risk Score Combined With Global Longitudinal Strain for Predicting Major Adverse Cardiac Events After PCI in Patients With ST-Segment Elevation Myocardial Infarction

2021 ◽  
Author(s):  
De Bin Yang ◽  
Ying Chun Wang ◽  
Wen Ye Zhu ◽  
Jing Wang ◽  
Lou Jin Rong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Risk Score ◽  
Coronary Intervention ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Percutaneous Coronary ◽  
Timi Risk Score

Abstract PurposeAccurately assessing the predicting prognosis is important in ST-segment elevation myocardial infarction (STEMI). This study aimed to investigate the predictive value of the TIMI risk score combined with GLS for the occurrence of major adverse cardiovascular events (MACEs)in STEMI patients after percutaneous coronary intervention (PCI)MethodsAcute STEMI diagnosed between January 2019 to June 2021 were prospectively enrolled. GLS were performed to assess left ventricular dysfunction three days post-percutaneous coronary intervention (PCI). In a 12-month follow up, three prognostic models for MACE were established based on TIMI risk score alone, TIMI risk score + GLS, and TIMI risk score + GLS + clinical risk factors, respectively, and assessed for efficiency.ResultsA total of 138 patients were enrolled. According to the follow-up results, the incidence of MACE in the patients was 19.6% (27/138). Areas under the receiver operating characteristic (ROC) curves were 0.703, 0.810 and 0.815, respectively, in TIMI risk score alone, TIMI risk score + GLS, TIMI risk score + GLS + clinical risk factors, indicating a significantly higher value and more efficient assessment for TIMI risk score + GLS.ConclusionCompared with the TIMI risk score alone, TIMI risk score combined with GLS provides a more efficient assessment of risk for determining the prognosis of STEMI patients.

scholarly journals Dyslipidemia and Conventional Risk Factors in Patients with Acute Coronary Syndrome Admitted in a CCU of a Tertiary Care Hospital of Bangladesh

2021 ◽  
Vol 14 (1) ◽  
pp. 24-29
Author(s):  
Md Mahfuzur Rahman ◽  
Farid Uddin Ahmed ◽  
Sanjida Sharmin ◽  
Tanvir Hyder ◽  
Saifuddin Nehal
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Risk Factor ◽  
Tertiary Care ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Conventional Risk Factors

Background: Coronary artery disease (CAD) is the single largest cause of death in the developed countries and is one of the leading causes of disease burden in developing countries. The prevalence of dyslipidemia and conventional risk factors profile at the time of admission in patients with Acute Coronary Syndrome (ACS) is not well described in our context. The aim of this study was to investigate the prevalence of dyslipidemia and conventional risk factors profiles of patients with ACS in a tertiary care center of Bangladesh. Methods: This descriptive cross-sectional study included 96 admitted patients of ACS [30 cases of Unstable Angina, 25 cases of Non ST segment Elevation Myocardial Infarction and 41 cases of ST segment Elevation Myocardial Infarction] from the Department of Cardiology, Abdul Malek Ukil Medical College Hospital, Noakhali, Bangladesh from January 2019 to June 2019. Fasting serum lipid profile was obtained within 24 hours of hospitalization and demographic and other cardiovascular risk factors were documented. Results: The mean age of the subjects were 57.7±14.4 years with majority (71.9%) being male. The most frequent reported risk factor was smoking, present in 55.2% of patients, followed by hypertension (47.9%), diabetes (37.5%), dyslipidemia (27.1%) and family history of CAD (15.6%). Based on Body Mass index 50% patients were obese (≥25kg/m2) and 69.8% had central obesity based on waist circumference. The lipid profile analysis revealed that 99% of patients had some type of dyslipidemia, and the most frequent was high level of triglyceride and low levels of high-density lipoprotein cholesterol (68.8% of cases in each). Conclusion: Dyslipidemia is a significant risk factor in patients with ACS and high TG and low HDL-C were more prevalent. Careful attention to its management may help to reduce further events. Cardiovasc j 2021; 14(1): 24-29

10-Year Follow-Up of Patients With Everolimus-Eluting Versus Bare-Metal Stents After ST-Segment Elevation Myocardial Infarction

2021 ◽  
Vol 77 (9) ◽  
pp. 1165-1178 ◽  
Author(s):  
Salvatore Brugaletta ◽  
Josep Gomez-Lara ◽  
Luis Ortega-Paz ◽  
Victor Jimenez-Diaz ◽  
Marcelo Jimenez ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Bare Metal Stents ◽  
Metal Stents ◽  
Bare Metal ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

scholarly journals Two-year clinical performance of Absorb BVS compared to Xience EES in ST-segment elevation myocardial infarction: a pooled analysis of AIDA and COMPARE-ABSORB trials

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
L.S.M Kerkmeijer ◽  
G Chao ◽  
R Tijssen ◽  
T Gori ◽  
R.P Kraak ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Target Lesion ◽  
Pooled Analysis ◽  
St Segment Elevation ◽  
Patient Level ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Absorb Bvs ◽  
Target Lesion Failure

Abstract Introduction Bioresorbable vascular scaffolds (BVS) use appears theoretically attractive in patients presenting with ST-segment elevation myocardial infarction (STEMI) as acute lesions are generally composed of soft plaques, in which optimal BVS deployment and expansion is easier to achieve. Furthermore, those patients are generally younger and would benefit longer from the promise of vascular restoration therapy. Purpose In this patient level pooled analysis of two clinical trials, we evaluated the clinical outcomes of Absorb BVS versus Xience everolimus-eluting stent (EES) in STEMI patients at 2-year follow-up. Methods We performed an individual patient-level pooled analysis of the AIDA and COMPARE-ABSORB trials in which 3515 patient were randomly assigned to Absorb BVS (n=1772) or Xience EES (n=1743). Clinical outcomes in STEMI patients were analyzed by randomized treatment assignment cumulative through 2 years. The primary efficacy outcomes measure was target lesion failure (cardiac death, target-vessel myocardial infarction or target lesion revascularization), and the primary safety outcome measure was device thrombosis at 2-year follow-up. Results 350 (19.8%) STEMI patients were allocated to Absorb BVS versus 328 (18.8%) to Xience EES. The mean age of patient presenting with STEMI was 60 years old, 76.0% were males and 15.3% had diabetes mellitus. At 2-years target lesion failure occurred in 8.4% of BVS STEMI patients and 6.2% of EES STEMI patients (p=0.253). The 2-year rates of cardiac death (2.6% vs 1.6%, p=0.332), TV-MI (4.7% vs 2.5%) and TLR (6.8% vs 4.1%) were not significantly different. The 2-year incidence of definite device thrombosis was 4.7% in Absorb BVS versus 1.8% in Xience EES (p=0.045). Conclusion In the present patient-level pooled analysis of the AIDA and COMPARE-Absorb trials, BVS was associated with increased rates of device thrombosis in STEMI patients compared to Xience EES. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Abbott

scholarly journals Analysis of risk factors for different subtypes of acute coronary syndrome

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110083
Author(s):  
Lei Zhang ◽  
Juledezi Hailati ◽  
Xiaoyun Ma ◽  
Jiangping Liu ◽  
Zhiqiang Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Brain Natriuretic Peptide ◽  
Left Ventricular ◽  
St Segment Elevation ◽  
Amino Terminal ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

Aims To investigate the different risk factors among different subtypes of patients with acute coronary syndrome (ACS). Methods A total of 296 patients who had ACS were retrospectively enrolled. Blood and echocardiographic indices were assessed within 24 hours after admission. Differences in risk factors and Gensini scores of coronary lesions among three groups were analyzed. Results Univariate analysis of risk factors for ACS subtypes showed that age, and levels of fasting plasma glucose, amino-terminal pro-brain natriuretic peptide, and creatine kinase isoenzyme were significantly higher in patients with non-ST-segment elevation myocardial infarction (NSTEMI) than in those with unstable angina pectoris (UAP). Logistic multivariate regression analysis showed that amino-terminal pro-brain natriuretic peptide and the left ventricular ejection fraction (LVEF) were related to ACS subtypes. The left ventricular end-diastolic diameter was an independent risk factor for UAP and ST-segment elevation myocardial infarction (STEMI) subtypes. The severity of coronary stenosis was significantly higher in NSTEMI and STEMI than in UAP. Gensini scores in the STEMI group were positively correlated with D-dimer levels (r = 0.429) and negatively correlated with the LVEF (r = −0.602). Conclusion Different subtypes of ACS have different risk factors. Our findings may have important guiding significance for ACS subtype risk assessment and clinical treatment.

scholarly journals A soft voting ensemble classifier for early prediction and diagnosis of occurrences of major adverse cardiovascular events for STEMI and NSTEMI during 2-year follow-up in patients with acute coronary syndrome

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0249338
Author(s):  
Syed Waseem Abbas Sherazi ◽  
Jang-Whan Bae ◽  
Jong Yun Lee
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Events ◽  
Ensemble Classifier ◽  
Major Adverse Cardiovascular Events ◽  
Test Dataset ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Complete Dataset ◽  
St Segment

Objective Some researchers have studied about early prediction and diagnosis of major adverse cardiovascular events (MACE), but their accuracies were not high. Therefore, this paper proposes a soft voting ensemble classifier (SVE) using machine learning (ML) algorithms. Methods We used the Korea Acute Myocardial Infarction Registry dataset and selected 11,189 subjects among 13,104 with the 2-year follow-up. It was subdivided into two groups (ST-segment elevation myocardial infarction (STEMI), non ST-segment elevation myocardial infarction NSTEMI), and then subdivided into training (70%) and test dataset (30%). Third, we selected the ranges of hyper-parameters to find the best prediction model from random forest (RF), extra tree (ET), gradient boosting machine (GBM), and SVE. We generated each ML-based model with the best hyper-parameters, evaluated by 5-fold stratified cross-validation, and then verified by test dataset. Lastly, we compared the performance in the area under the ROC curve (AUC), accuracy, precision, recall, and F-score. Results The accuracies for RF, ET, GBM, and SVE were (88.85%, 88.94%, 87.84%, 90.93%) for complete dataset, (84.81%, 85.00%, 83.70%, 89.07%) STEMI, (88.81%, 88.05%, 91.23%, 91.38%) NSTEMI. The AUC values in RF were (98.96%, 98.15%, 98.81%), ET (99.54%, 99.02%, 99.00%), GBM (98.92%, 99.33%, 99.41%), and SVE (99.61%, 99.49%, 99.42%) for complete dataset, STEMI, and NSTEMI, respectively. Consequently, the accuracy and AUC in SVE outperformed other ML models. Conclusions The performance of our SVE was significantly higher than other machine learning models (RF, ET, GBM) and its major prognostic factors were different. This paper will lead to the development of early risk prediction and diagnosis tool of MACE in ACS patients.

Sign in / Sign up

Export Citation Format

Share Document