Long-term follow-up of percutaneous peripheral interventions in lower limb arteries in patients with acute coronary syndrome and diabetes

Aim To study a relationship of several factors (clinical and genetical markers) with unfavorable outcomes in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) in long-term follow-up.Material and methods This full-design, prospective study included 415 patients with NSTE-ACS. 266 patients were evaluated for the presence of multifocal atherosclerosis (MFA). Typing of polymorphic variants rs1041981 LTA, rs1800629 TNF, rs4986790, and rs498679 TLR4, and also rs3024491 and rs1800872 IL10 was performed. Follow-up period lasted for 67±4 months. By the end of this period, information about clinical outcomes for 396 patients became available.Results During the entire follow-up period, unfavorable outcomes were observed in 239 (57.5 %) patients with NSTE-ACS. The following clinical signs were associated with unfavorable outcomes: history of myocardial infarction, age >56 years, left ventricular ejection fraction (LV EF) ≤50 % and GRACE score ≥100, significant stenosis of brachiocephalic arteries, MFA, carriage of genotype А / А rs1041981 LTA (OR, 6.1; р=0.02) and allele А (OR, 1.9; р=0.01). According to results of a multifactorial analysis, the most significant predictors included LV EF <50 %, MFA, and carriage of genotype А / А rs1041981 LTA.Conclusion Stratification of patients with NSTE-ACS into groups of high or low risk for having an unfavorable outcome within the next 6 years is possible using the prognostic model developed and presented in this study. The model includes the following signs: LV EF <50 %, MFA, and carriage of genotype А / А rs1041981 LTA.

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Short- and long-term follow-up of antithrombotic management patterns in patients hospitalized with acute coronary syndrome: Indian subgroup of EPICOR Asia study

Indian Heart Journal ◽

10.1016/j.ihj.2018.12.005 ◽

2019 ◽

Vol 71 (1) ◽

pp. 25-31 ◽

Cited By ~ 1

Author(s):

J.P.S. Sawhney ◽

Ajit Mullasari ◽

Dhiman Kahali ◽

Vimal Mehta ◽

Tiny Nair ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Coronary Syndrome ◽

Long Term Follow Up ◽

Short And Long Term ◽

Antithrombotic Management

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Cardiovascular Events During Long Term Follow-Up After Cessation of Dual Antiplatelet Therapy in Patients with Acute Coronary Syndrome

International Journal of Cardiology ◽

10.1016/j.ijcard.2017.09.072 ◽

2017 ◽

Vol 249 ◽

pp. S17

Author(s):

W. Mazlan-Kepli ◽

J. Dawson ◽

C. Berry ◽

M. Walters

Keyword(s):

Acute Coronary Syndrome ◽

Antiplatelet Therapy ◽

Cardiovascular Events ◽

Dual Antiplatelet Therapy ◽

Coronary Syndrome ◽

Long Term Follow Up

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Impact of known or new-onset atrial fibrillation on 2-year cardiovascular event rate in patients with acute coronary syndromes: results from the prospective EPICOR Registry

European Heart Journal Acute Cardiovascular Care ◽

10.1177/2048872618769057 ◽

2018 ◽

Vol 8 (2) ◽

pp. 121-129 ◽

Cited By ~ 10

Author(s):

Uwe Zeymer ◽

Lieven Annemans ◽

Nicolas Danchin ◽

Stuart Pocock ◽

Simon Newsome ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Antiplatelet Therapy ◽

Dual Antiplatelet Therapy ◽

Oral Anticoagulants ◽

Composite Endpoint ◽

Coronary Syndrome ◽

Long Term Follow Up ◽

New Onset

Background: Atrial fibrillation (AF) is associated with increased morbidity in acute coronary syndrome patients, but impact on outcomes beyond 1 year is unclear. Methods: This was a post-hoc analysis from the long-tErm follow-uP of antithrombotic management patterns In acute CORonary syndrome patients (EPICOR) registry (NCT01171404), a prospective, observational study conducted in Europe and Latin America, which enrolled acute coronary syndrome survivors at discharge. Antithrombotic management patterns, mortality, a composite endpoint of death/new non-fatal myocardial infarction/stroke and bleeding events were assessed after 2 years of follow-up in patients with or without AF. Results: Of 10,568 patients enrolled, 397 (4.7%) had prior AF and 382 (3.6%) new-onset AF during index hospitalisation. Fewer patients with AF underwent percutaneous coronary intervention (52.1% vs. 66.6%; P<0.0001). At discharge, fewer AF patients received dual antiplatelet therapy (71.6% vs. 89.5%; P<0.0001); oral anticoagulant use was higher in AF patients but was still infrequent (35.0% vs. 2.5%; P<0.0001). Use of dual antiplatelet therapy and oral anticoagulants declined over follow-up with over 50% of all AF/no AF patients remaining on dual antiplatelet therapy (55.6% vs. 60.6%), and 23.3% (new-onset AF) to 42.1% (prior AF) on oral anticoagulants at 2 years. At 2 years, mortality, composite endpoint and bleeding rates were higher in AF patients (all P<0.0001) compared to patients without AF. On multivariable analysis, the risk of mortality or the composite endpoint was significant for prior AF ( P=0.003, P=0.001) but not new-onset AF ( P=0.88, P=0.92). Conclusions: Acute coronary syndrome patients with AF represent a high-risk group with increased event rates during long-term follow-up. Prior AF is an independent predictor of mortality and/or ischaemic events at 2 years. Use of anticoagulants in AF after acute coronary syndrome is still suboptimal.

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