The burden of major adverse cardiac events in patients with coronary artery diseaseReport as inadecuate

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BMC Cardiovascular Disorders

, 17:1

Coronary artery disease


BackgroundPatients with a history of cardiovascular disease are at high risk of developing secondary major adverse cardiac events MACE. This study aimed to identify independent predictors of MACE after hospital admission which could be used to identify of high-risk patients who may benefit from preventive strategies.

MethodsThis study included 1,520 consecutive patients with coronary artery disease CAD 654 with acute coronary syndrome ACS and 866 with elective percutaneous coronary intervention PCI patients who received PCI and-or stenting. MACE was defined as all-cause mortality or rehospitalization for a cardiovascular- related illness. Cardiovascular-related illnesses included heart failure, reinfarction nonfatal, recurrence of angina pectoris and repeat PCI or coronary artery bypass graft.

ResultsDuring a mean follow-up period of 32 months, 558 of the 1,520 patients developed at least one MACE. Cox regression analysis showed that the baseline clinical and biochemical variables which associated with MACE were age, being illiterate, a widow or widower, and-or economically dependent, having triple vessel disease, stent implantation, anemia, and-or diabetes mellitus, waist to hip ratio WHR, diastolic blood pressure, fasting glucose, total cholesterol, high-density lipoprotein cholesterol HDL-C, creatinine, estimated glomerular filtration rate eGFR, red blood cell count, hemoglobin, hematocrit, and mean corpuscular-hemoglobin concentration MCHC in ACS patients, and age, malnourished, and-or economically dependent, taking hypoglycemic medication, having triple vessel disease, stent implantation, anemia, diabetes mellitus, and-or hypertension, WHR, fasting glucose, HDL-C, uric acid, creatinine, eGFR, high-sensitivity C-reactive protein, mean corpuscular volume, and MCHC in elective PCI patients. Using multivariate Cox regression analysis, we found the MACE’s independent factors are triple vessel disease, stent implantation, hypertension, and eGFR in ACS patients, and having triple vessel disease, stent implantation, hypertension, and uric acid in elective PCI patients.

ConclusionsHaving triple vessel disease, stent implantation, hypertension, and eGFR or uric acid independently predicted MACE in patients with CAD after long-term follow-up. Fortunately, these factors are modifiable and should be identified and monitored early.

KeywordsMajor adverse cardiovascular events Predictive factors Coronary artery disease AbbreviationsACSacute coronary syndrome

AUCarea under the curves

BMIbody mass index.

CABGcoronary artery bypass graft

CADCoronary artery disease

CKDChronic kidney disease

eGFREstimated glomerular filtration rate

HbA1cHemoglobin A1c

HDLHigh-density lipoprotein

HFHeart failure

CRPC-reactive protein

HRHazard ratio

LDLLow-density lipoprotein

MACEMajor adverse cardiac events

MCHCMean corpuscular-hemoglobin concentration

MIMyocardial infarction

PCIPercutaneous coronary intervention

RBCRed blood cell

ROCReceiver operating characteristic

WBCWhite blood cell

WHRWaist to hip ratio

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Author: I-Ting Tsai - Chao-Ping Wang - Yung-Chuan Lu - Wei-Chin Hung - Cheng-Ching Wu - Li-Fen Lu - Fu-Mei Chung - Chia-Chang Hsu


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