Atherogenic Index of Plasma and the Risk of In-Stent Restenosis in Patients with Acute Coronary Syndrome beyond the Traditional Risk Factors

Background Restenosis after percutaneous coronary intervention (PCI) was earlier thought to be a benign event clinically manifested as stable exertional angina. The aim of this prospective multicenter registry study was to investigate the incidence of acute coronary syndrome in patients with restenosis in Sweden. Methods Using data from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR), we analyzed all registered cases of PCI for restenosis (in-stent, after balloon angioplasty) from 1995 to 2005 in Sweden. Both multivessel and single vessel interventions were included. Restenosis presentations were classified as: stable angina; unstable angina/non-STEMI; STEMI; and other reasons. As routine angiographic screening was not performed, restenosis episodes were defined clinically based on symptoms. Results We identified 6642 cases of restenosis in 2978 patients (4790 in men, 1852 in women). Restenosis presented in 39.7% of cases as stable angina, in 46.0% as unstable angina/non-STEMI, in 11.5% as STEMI and in 2.8% as other reasons. Cardiogenic shock was reported in 48 patients. Women had a higher incidence of unstable angina/non-STEMI compared with men (52.3% v. 43.6%) but a lower incidence of STEMI (9.6% v. 12.2%). The frequency of STEMI was lower with restenosis after balloon angioplasty v. in-stent restenosis (6.9% v. 13.8%), and after drug-eluting stents v. bare metal stents (7.9% v. 18.5%). Mortality rate was 1.7% at 30 days, 3.2% at 6 months and 4.6% at one year in patients with restenosis. These covariates were independent predictors of acute coronary syndrome: gender, age, vessel diameter, smoking, stent type, number of stents, treated vessel, previous stroke and previous infarction. Conclusion The majority of patients with coronary restenosis present either with acute MI or unstable angina requiring hospitalization and new interventions. Women may have a higher risk of developing acute coronary syndrome due to restenosis. Prevention of restenosis may be an important target for improvement of “hard” clinical outcomes in patients undergoing coronary revascularization.

Download Full-text

Two parameters reflect lipid-driven inflammatory state in acute coronary syndrome: atherogenic index of plasma, neutrophil–lymphocyte ratio

BMC Cardiovascular Disorders ◽

10.1186/s12872-016-0274-7 ◽

2016 ◽

Vol 16 (1) ◽

Cited By ~ 15

Author(s):

Youqin Zhan ◽

Tan Xu ◽

Xuerui Tan

Keyword(s):

Acute Coronary Syndrome ◽

Atherogenic Index ◽

Atherogenic Index Of Plasma ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Coronary Syndrome ◽

Inflammatory State ◽

Two Parameters

Download Full-text

TCT-11: In-Stent Restenosis is Not a Benign Clinical Entity, Presenting As Acute Coronary Syndrome In 40 % Of Cases

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2011.10.014 ◽

2011 ◽

Vol 58 (20) ◽

pp. B3-B4

Keyword(s):

Acute Coronary Syndrome ◽

Clinical Entity ◽

Coronary Syndrome ◽

Stent Restenosis ◽

In Stent Restenosis

Download Full-text

The correlation between traditional risk factors and the severity of acute coronary syndrome and long-term prognosis

Cardiosomatics ◽

10.26442/cs45150 ◽

2015 ◽

Vol 6 (4) ◽

pp. 6-10

Author(s):

I. S Skopets ◽

N. N Vezikova ◽

I. M Marusenko ◽

O. Yu Barysheva

Keyword(s):

Risk Factors ◽

Acute Coronary Syndrome ◽

Family History ◽

Coronary Syndrome ◽

Increased Risk ◽

Life Threatening ◽

Traditional Risk Factors ◽

Long Term Prognosis

A number of studies demonstrate that patients with traditional risk factors (TRF) have not only increases primary risk of atherothrombotic events, but are also associated with many complicates and poor prognosis.Purpose: assessment of TRF effect on the incidence of complications and outcomes in patients with acute coronary syndrome (ACS).Materials and methods: in 255 patients hospitalized with ACS were retrospective determined the TRF prevalence, frequency of the complications and correlation between the presence of TRF and the risk of complications and long-term prognosis (follow-up 1 year).Results: patients had TRF very often, 80% patients had more than 3 TRFs. The presence of some TRFs (smoking, abdominal obesity, family history) was associated with a significantly increased risk of complications in patients with ACS, including life-threatening. Effect of TRF on long-term prognosis was not determined.Conclusion: the findings suggest the need to evaluation TRF not only in primary preventive and also to improve the effectiveness of risk stratification in patients with ACS.

Download Full-text

Evaluation of the long-term prognostic ability of triglyceride-glucose index for elderly acute coronary syndrome patients: a cohort study

Cardiovascular Diabetology ◽

10.1186/s12933-021-01443-y ◽

2022 ◽

Vol 21 (1) ◽

Author(s):

Yang Jiao ◽

Yongkang Su ◽

Jian Shen ◽

Xiaoling Hou ◽

Ying Li ◽

...

Keyword(s):

Risk Factors ◽

Acute Coronary Syndrome ◽

Adverse Events ◽

World Population ◽

Coronary Syndrome ◽

Tyg Index ◽

All Cause Mortality ◽

The Mean ◽

Traditional Risk Factors

Abstract Background With the advancement of the world population aging, more attention should be paid to the prognosis of elderly patients with acute coronary syndrome (ACS). Triglyceride-glucose (TyG) index is a reliable indicator of insulin resistance (IR) and is closely related to traditional risk factors of cardiovascular disease (CVD). However, the effect of TyG index on the prognosis of long-term adverse events in elderly ACS patients has not been reported. This study evaluated the prognostic power of TyG index in predicting adverse events in elderly ACS patients. Methods In this study, 662 ACS patients > 80 years old who were hospitalized from January 2006 to December 2012 were enrolled consecutively and the general clinical data and baseline blood biochemical indicators were collected. The follow-up time after discharge was 40–120 months (median, 63 months; interquartile range, 51‒74 months). In addition, the following formula was used to calculate the TyG index: Ln [fasting TG (mg/dL) × FBG (mg/dL)/2], and patients were divided into three groups according to the tertile of the TyG index. Results The mean age of the subjects was 81.87 ± 2.14 years, the proportion of females was 28.10%, and the mean TyG index was 8.76 ± 0.72. The TyG index was closely associated with the traditional risk factors of CVD. In the fully-adjusted Cox regression model, the Hazard ratio (95% CI) of all-cause mortality (in tertile 3) was 1.64 (1.06, 2.54) and major adverse cardiac event (MACE) (in tertile 3) was 1.36 (1.05, 1.95) for each SD increase in the TyG index. The subgroup analyses also confirmed the significant association of the TyG index and long-term prognosis. Conclusion The TyG index is an independent predictor of long-term all-cause mortality and MACE in elderly ACS patients.

Download Full-text

Atherogenic index of plasma and coronary artery calcification progression beyond traditional risk factors according to baseline coronary artery calcium score

Scientific Reports ◽

10.1038/s41598-020-78350-x ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Ki-Bum Won ◽

Donghee Han ◽

Ji Hyun Lee ◽

Su-Yeon Choi ◽

Eun Ju Chun ◽

...

Keyword(s):

Risk Factors ◽

Coronary Artery ◽

Coronary Artery Calcium ◽

Coronary Artery Calcification ◽

Coronary Artery Calcium Score ◽

Calcium Score ◽

Atherogenic Index ◽

Atherogenic Index Of Plasma ◽

Traditional Risk Factors

AbstractThis study aimed to evaluate the association between the atherogenic index of plasma (AIP), which has been suggested as a novel marker for atherosclerosis, and coronary artery calcification (CAC) progression according to the baseline coronary artery calcium score (CACS). We included 12,326 asymptomatic Korean adults who underwent at least two CAC evaluations from December 2012 to August 2016. Participants were stratified into four groups according to AIP quartiles, which were determined by the log of (triglyceride/high-density lipoprotein cholesterol). Baseline CACSs were divided into three groups: 0, 1 − 100, and > 100. CAC progression was defined as a difference ≥ 2.5 between the square roots (√) of the baseline and follow-up CACSs (Δ√transformed CACS). Annualized Δ√transformed CACS was defined as Δ√transformed CACS divided by the inter-scan period. During a mean 3.3-year follow-up period, the overall incidence of CAC progression was 30.6%. The incidences of CAC progression and annualized Δ√transformed CACS were markedly elevated with increasing AIP quartile in participants with baseline CACSs of 0 and 1 − 100, but not in those with a baseline CACS > 100. The AIP level was associated with the annualized Δ√transformed CACS in participants with baseline CACSs of 0 (β = 0.016; P < 0.001) and 1 − 100 (β = 0.035; P < 0.001), but not in those with baseline CACS > 100 (β = 0.032; P = 0.385). After adjusting for traditional risk factors, the AIP was significantly associated with CAC progression in those with baseline CACS ≤ 100. The AIP has value for predicting CAC progression in asymptomatic adults without heavy baseline CAC.

Download Full-text

Risk Factors Associated with Acute Coronary Syndrome after Successful Percutaneous Coronary Intervention

Acta Medica Marisiensis ◽

10.1515/amma-2017-0036 ◽

2017 ◽

Vol 63 (4) ◽

pp. 170-172

Author(s):

Violeta Dinesch ◽

Mihail Dinesch ◽

Ileana Voichita Sirbu ◽

Cosmin Macarie ◽

Mircea Buruian

Keyword(s):

Percutaneous Coronary Intervention ◽

Acute Coronary Syndrome ◽

Coronary Intervention ◽

Bare Metal Stent ◽

Bare Metal ◽

Metal Stent ◽

Coronary Syndrome ◽

Stent Restenosis ◽

Percutaneous Coronary ◽

In Stent Restenosis

AbstractObjective: Admission for acute coronary syndrome after successful percutaneous coronary intervention is a delicate situation for the patient and doctor. Predictors of these cases are poorly described.Methods: We retrospectively analysed the files of post-percutaneous coronary intervention patients admitted to the Department of Cardiology of the Institute for Cardiovascular Disease and Heart Transplant in Tirgu Mures between January 2012 and December 2015. Analyses using the t-test, chi-square test, and Fisher test were performed to compare demographics, clinical and angiographic characteristics of patients with acute coronary syndrome, patients with stable angina, and those without symptoms.Results: One hundred eighty post-percutaneous coronary intervention patients were readmitted; 46 patients (25.55%) were readmitted for acute coronary syndrome. Histories of arterial hypertension and renal dysfunction at hospital admission were associated with acute coronary syndrome. Bare metal stent in-stent restenosis and localisation of bare metal stent in-stent restenosis of the left descendent coronary artery were angiographic predictors of acute coronary syndrome.Conclusion: Several clinical and angiographic factors identify patients at high risk for acute coronary syndrome after successful percutaneous coronary intervention. Recognition and treatment of these factors may prevent readmission for such a dangerous condition and may improve outcomes.

Download Full-text