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Naganawa H, Ito A, Saiki S, Nishi D, Takamatsu S, Ito Y, Suzuki T. The Efficacy of Drug-Coated Balloon for Acute Coronary Syndrome. Cardiol Res Pract 2023; 2023:4594818. [PMID: 37122873 PMCID: PMC10139813 DOI: 10.1155/2023/4594818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 01/01/2023] [Accepted: 04/15/2023] [Indexed: 05/02/2023] Open
Abstract
Background Percutaneous coronary intervention using a drug-eluting stent (DES) is a common therapeutic option for acute coronary syndrome (ACS). However, stent-associated complications, such as bleeding associated with dual antiplatelet therapy, in-stent restenosis, stent thrombosis, and neoatherosclerosis, remain. Drug-coated balloons (DCBs) are expected to reduce stent-associated complications. This study aimed to assess the efficacy of DCB therapy and compare it with that of DES therapy in patients with ACS. Materials and Methods In this single-center, retrospective, observational study, we examined all patients with ACS treated with DCB or DES between July 2014 and November 2020. Patients with left main trunk lesions were excluded. The primary outcome was a composite of major adverse cardiovascular events (MACE: cardiac death, myocardial infarction, and target lesion revascularization) at one year. Results Three hundred and seventy-two patients were treated with DES, and 83 patients were treated with DCB. MACE occurred in 10 (12.0%) patients in the DCB group and in 50 (13.4%) patients in the DES group (P=0.73). Conclusions DCB is a valuable and effective therapy for patients with ACS. Moreover, DCB may become an alternative therapy for DES in patients with ACS.
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Affiliation(s)
- Hirokazu Naganawa
- Department of Cardiology, Toyokawa City Hospital, Toyokawa, Aichi, Japan
| | - Akira Ito
- Department of Cardiology, Toyokawa City Hospital, Toyokawa, Aichi, Japan
| | - Shinrou Saiki
- Department of Cardiology, Toyokawa City Hospital, Toyokawa, Aichi, Japan
| | - Daisuke Nishi
- Department of Cardiology, Toyokawa City Hospital, Toyokawa, Aichi, Japan
| | - Shinichi Takamatsu
- Department of Cardiology, Toyokawa City Hospital, Toyokawa, Aichi, Japan
| | - Yoshihisa Ito
- Department of Cardiology, Toyokawa City Hospital, Toyokawa, Aichi, Japan
| | - Takeshi Suzuki
- Department of Cardiology, Toyokawa City Hospital, Toyokawa, Aichi, Japan
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2
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Affiliation(s)
- Ralf E Harskamp
- Department of general practice, Amsterdam UMC, location University of Amsterdam, Meibergdreef 9, Amsterdam, Netherlands
| | - Alexander C Fanaroff
- Division of Cardiology, Perelman School of Medicine, University of Pennsylvania, PA, USA
| | - Sinead Wang Zhen
- Duke-NUS family medicine, SingHealth Polyclinics, Singapore, Singapore
| | - Hendry R Sawe
- Emergency Medicine Department, Muhimbili University of Health and Allied Science, Dar es Salaam, Tanzania
| | - Ellen J Weber
- Department of Emergency Medicine, University of California, San Francisco, USA
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3
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Chao CJ, Shanbhag A, Chiang CC, Girardo ME, Seri AR, Khalid MU, Rayfield C, O'Shea MP, Fatunde O, Fortuin FD. Baseline thrombocytopenia in acute coronary syndrome: The lower, the worse. Int J Cardiol 2021; 332:1-7. [PMID: 33785391 DOI: 10.1016/j.ijcard.2021.03.059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 03/18/2021] [Accepted: 03/22/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Patients with baseline thrombocytopenia can have increased mortality and morbidity, but are typically excluded from randomized clinical trials studying acute coronary syndromes (ACS). We sought to better define the effect thrombocytopenia on clinical outcomes in ACS patients. METHODS Patients identified from the NCDR Chest Pain registry at Mayo Clinic Arizona from Oct 2015 to Sep 2018 were retrospectively classified into two groups: TP (platelet <150 × 103 μL) and control (platelet ≥150 × 103 μL). The groups were analyzed for the clinical outcome (all-cause mortality, major adverse cardiac events (MACE), and bleeding events). The TP group was divided into moderate-severe thrombocytopenia (TPmod; platelet 50-100 × 103 μL) and mild thrombocytopenia (TPmild; platelet 100-150 × 103 μL) for further analysis. P-value <0.05 is considered significant. RESULTS Five hundred and thirty-six patients were identified, and 72 patients (13%) had thrombocytopenia. The median follow-up time was 1.1 years. The TP group was older (TP vs. control: mean age 73 ± 13 years vs. 70 ± 13 years; P = 0.026). In patients discharged on dual-antiplatelet therapy, the TP group had higher all-cause mortality (23% vs. 7.3%; P = 0.007) but not major bleeding events (11% vs. 5.0%; P = 0.123). Only all-cause mortality increased with the severity of thrombocytopenia (TPmod vs. TPmild vs. control: 33% vs. 24% vs. 7.3%; P = 0.007). CONCLUSIONS In patients with ACS, baseline thrombocytopenia is associated with increased all-cause mortality and all bleeding events without net MACE benefit. Further study is needed to identify the optimal antiplatelet strategy in this higher risk population.
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Affiliation(s)
- Chieh-Ju Chao
- Department of Cardiovascular Diseases, Mayo Clinic Arizona, Phoenix, AZ, United States of America.
| | - Anusha Shanbhag
- Department of Cardiovascular Diseases, Mayo Clinic Arizona, Phoenix, AZ, United States of America.
| | - Chia-Chun Chiang
- Department of Neurology, Mayo Clinic Rochester, Phoenix, AZ, United States of America
| | - Marlene E Girardo
- Department of Research, Division of Biomedical Statistics and Informatics, Mayo Clinic Arizona, Phoenix, AZ, United States of America
| | - Amith R Seri
- Department of Cardiovascular Diseases, Mayo Clinic Arizona, Phoenix, AZ, United States of America
| | - Muhammad U Khalid
- Department of Cardiovascular Diseases, Mayo Clinic Arizona, Phoenix, AZ, United States of America
| | - Corbin Rayfield
- Department of Cardiovascular Diseases, Mayo Clinic Arizona, Phoenix, AZ, United States of America.
| | - Michael P O'Shea
- Department of Cardiovascular Diseases, Mayo Clinic Arizona, Phoenix, AZ, United States of America
| | - Olubadewa Fatunde
- Department of Cardiovascular Diseases, Mayo Clinic Arizona, Phoenix, AZ, United States of America.
| | - F David Fortuin
- Department of Cardiovascular Diseases, Mayo Clinic Arizona, Phoenix, AZ, United States of America.
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4
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Gheini A, Pooria A, Pourya A. Evaluating Mortality Rate and Associated Parameters in Patients with Acute Coronary Syndrome. Cardiovasc Hematol Disord Drug Targets 2020; 20:221-226. [PMID: 32646364 DOI: 10.2174/1871529x20666200709130533] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 05/05/2020] [Accepted: 06/03/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Acute coronary syndrome (ACS) is one of the leading causes of mortality worldwide and is characterized by unstable angina or acute myocardial infarction. The aim of this study is to evaluate the clinical characteristics of patients who died of ACS. METHODS In this cross-sectional study, 1000 patients presenting ACS were included. Data and records of these patients were evaluated for parameters such as; deceased status, age, gender, diagnosis, ECG, common complaints, associated risk factors, Killip class, pulse, blood pressure, geographic setup (urban or rural), complications and season in which the disease was presented. Statistical analysis was performed on the data obtained using SPSS-win software. RESULTS The mortality rate among ACS patients in our study was 7.1%. Of these patients, AMI was the most prevalent diagnosis and chest pain was the most common complaint. Furthermore, low blood pressure, advanced age, increased pulse rate and fall/winter season were associated with the increased risk of mortality. ST deviation was the most seen ECG finding and most of the mortalities were within the 24 hours of admission. CONCLUSION Our study reports risk factors associated with mortality in ACS patients. Advanced and timely therapeutic measurements are likely to reduce the incidence of mortality in these patients.
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Affiliation(s)
- Alireza Gheini
- Department of Cardiology, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Ali Pooria
- Department of Cardiology, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Afsoun Pourya
- Student of Research Committee, Tehran University of Medical Sciences, Tehran, Iran
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5
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Levine DA, Langa KM, Galecki A, Kabeto M, Morgenstern LB, Zahuranec DB, Giordani B, Lisabeth LD, Nallamothu BK. Mild Cognitive Impairment and Receipt of Treatments for Acute Myocardial Infarction in Older Adults. J Gen Intern Med 2020; 35:28-35. [PMID: 31410812 PMCID: PMC6957594 DOI: 10.1007/s11606-019-05155-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 02/27/2019] [Accepted: 05/01/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Older adults with mild cognitive impairment (MCI) should receive evidence-based treatments when indicated. Providers and patients may overestimate the risk of dementia in patients with MCI leading to potential under-treatment. However, the association between pre-existing MCI and receipt of evidence-based treatments is uncertain. OBJECTIVE To compare receipt of treatments for acute myocardial infarction (AMI) between older adults with pre-existing MCI and cognitively normal patients. DESIGN Prospective study using data from the nationally representative Health and Retirement Study, Medicare, and American Hospital Association. PARTICIPANTS Six hundred nine adults aged 65 or older hospitalized for AMI between 2000 and 2011 and followed through 2012 with pre-existing MCI (defined as modified Telephone Interview for Cognitive Status score of 7-11) and normal cognition (score of 12-27). MAIN MEASURES Receipt of cardiac catheterization and coronary revascularization within 30 days and cardiac rehabilitation within 1 year of AMI hospitalization. KEY RESULTS Among the survivors of AMI, 19.2% had pre-existing MCI (55.6% were women and 44.4% were male, with a mean [SD] age of 82.3 [7.5] years), and 80.8% had normal cognition (45.7% were women and 54.3% were male, with a mean age of 77.1 [7.1] years). Survivors of AMI with pre-existing MCI were significantly less likely than those with normal cognition to receive cardiac catheterization (50% vs 77%; P < 0.001), coronary revascularization (29% vs 63%; P < 0.001), and cardiac rehabilitation (9% vs 22%; P = 0.001) after AMI. After adjusting for patient and hospital factors, pre-existing MCI remained associated with lower use of cardiac catheterization (adjusted hazard ratio (aHR), 0.65; 95% CI, 0.48-0.89; P = 0.007) and coronary revascularization (aHR, 0.55; 95% CI, 0.37-0.81; P = .003), but not cardiac rehabilitation (aHR, 1.01; 95% CI, 0.49-2.07; P = 0.98). CONCLUSIONS Pre-existing MCI is associated with lower use of cardiac catheterization and coronary revascularization but not cardiac rehabilitation after AMI.
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Affiliation(s)
- Deborah A Levine
- Department of Internal Medicine, University of Michigan (U-M), North Campus Research Complex, 2800 Plymouth Road, Building 16, Room 430W, Ann Arbor, MI, 48109-2800, USA. .,Department of Neurology and Stroke Program, U-M, Ann Arbor, MI, USA. .,Institute for Healthcare Policy and Innovation, U-M, Ann Arbor, MI, USA.
| | - Kenneth M Langa
- Department of Internal Medicine, University of Michigan (U-M), North Campus Research Complex, 2800 Plymouth Road, Building 16, Room 430W, Ann Arbor, MI, 48109-2800, USA.,Institute for Healthcare Policy and Innovation, U-M, Ann Arbor, MI, USA.,VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.,Institute for Social Research, U-M, Ann Arbor, MI, USA
| | - Andrzej Galecki
- Department of Internal Medicine, University of Michigan (U-M), North Campus Research Complex, 2800 Plymouth Road, Building 16, Room 430W, Ann Arbor, MI, 48109-2800, USA.,Department of Biostatistics, U-M, Ann Arbor, MI, USA
| | - Mohammed Kabeto
- Department of Internal Medicine, University of Michigan (U-M), North Campus Research Complex, 2800 Plymouth Road, Building 16, Room 430W, Ann Arbor, MI, 48109-2800, USA
| | | | | | - Bruno Giordani
- Department of Psychiatry & Michigan Alzheimer's Disease Center, U-M, Ann Arbor, MI, USA
| | - Lynda D Lisabeth
- Department of Neurology and Stroke Program, U-M, Ann Arbor, MI, USA.,Department of Epidemiology, U-M, Ann Arbor, MI, USA
| | - Brahmajee K Nallamothu
- Department of Internal Medicine, University of Michigan (U-M), North Campus Research Complex, 2800 Plymouth Road, Building 16, Room 430W, Ann Arbor, MI, 48109-2800, USA.,Institute for Healthcare Policy and Innovation, U-M, Ann Arbor, MI, USA.,VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
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6
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Benjamin EJ, Virani SS, Callaway CW, Chamberlain AM, Chang AR, Cheng S, Chiuve SE, Cushman M, Delling FN, Deo R, de Ferranti SD, Ferguson JF, Fornage M, Gillespie C, Isasi CR, Jiménez MC, Jordan LC, Judd SE, Lackland D, Lichtman JH, Lisabeth L, Liu S, Longenecker CT, Lutsey PL, Mackey JS, Matchar DB, Matsushita K, Mussolino ME, Nasir K, O'Flaherty M, Palaniappan LP, Pandey A, Pandey DK, Reeves MJ, Ritchey MD, Rodriguez CJ, Roth GA, Rosamond WD, Sampson UKA, Satou GM, Shah SH, Spartano NL, Tirschwell DL, Tsao CW, Voeks JH, Willey JZ, Wilkins JT, Wu JH, Alger HM, Wong SS, Muntner P. Heart Disease and Stroke Statistics-2018 Update: A Report From the American Heart Association. Circulation 2018; 137:e67-e492. [PMID: 29386200 DOI: 10.1161/cir.0000000000000558] [Citation(s) in RCA: 4513] [Impact Index Per Article: 752.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Tektonidou MG, Wang Z, Ward MM. Brief Report: Trends in Hospitalizations Due to Acute Coronary Syndromes and Stroke in Patients With Systemic Lupus Erythematosus, 1996 to 2012. Arthritis Rheumatol 2017; 68:2680-2685. [PMID: 27273732 DOI: 10.1002/art.39758] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 05/12/2016] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Cardiovascular disease (CVD) has been recognized as a major cause of morbidity in patients with systemic lupus erythematosus (SLE), but it is not clear whether increased awareness of these risks has translated into improvements in CVD morbidity at the population level. The aim of this study was to examine trends in hospitalization rates for CVD events in a representative sample of adult patients with SLE in the US from 1996 to 2012. METHODS We used the Nationwide Inpatient Sample to estimate the rates of hospitalization for acute myocardial infarction (MI), unstable angina, and ischemic stroke from 1996 to 2012 in patients with SLE. We compared these trends with those in the general population. RESULTS During the study years, there were an estimated 31,012 hospitalizations for acute MI, 4,160 hospitalizations for unstable angina, and 26,144 hospitalizations for ischemic stroke among patients with SLE. The rates of hospitalization for acute MI and ischemic stroke increased over time in patients with SLE, while the rates for unstable angina decreased. The rates for all 3 conditions decreased in the general population over these years, with hospitalization rates for unstable angina decreasing faster in the general population than in patients with SLE. CONCLUSION Increased awareness of the burden of CVD in patients with SLE has not yet translated into decreased rates of hospitalization for acute MI or stroke. This may be due to barriers in implementation of CVD risk factor modification or to SLE-specific risks that have not yet been identified or effectively targeted.
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Affiliation(s)
- Maria G Tektonidou
- First Department of Internal Medicine, Joint Academic Rheumatology Programme, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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8
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Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, de Ferranti SD, Floyd J, Fornage M, Gillespie C, Isasi CR, Jiménez MC, Jordan LC, Judd SE, Lackland D, Lichtman JH, Lisabeth L, Liu S, Longenecker CT, Mackey RH, Matsushita K, Mozaffarian D, Mussolino ME, Nasir K, Neumar RW, Palaniappan L, Pandey DK, Thiagarajan RR, Reeves MJ, Ritchey M, Rodriguez CJ, Roth GA, Rosamond WD, Sasson C, Towfighi A, Tsao CW, Turner MB, Virani SS, Voeks JH, Willey JZ, Wilkins JT, Wu JH, Alger HM, Wong SS, Muntner P. Heart Disease and Stroke Statistics-2017 Update: A Report From the American Heart Association. Circulation 2017; 135:e146-e603. [PMID: 28122885 PMCID: PMC5408160 DOI: 10.1161/cir.0000000000000485] [Citation(s) in RCA: 6083] [Impact Index Per Article: 869.0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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9
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Bueno H, de Graeff P, Richard-Lordereau I, Emmerich J, Fox KA, Friedman CP, Gaudin C, El-Gazayerly A, Goldman S, Hemmrich M, Henderson RA, Himmelmann A, Irs A, Jackson N, James SK, Katus HA, Laslop A, Laws I, Mehran R, Ong S, Prasad K, Roffi M, Rosano GM, Rose M, Sinnaeve PR, Stough WG, Thygesen K, Van de Werf F, Varin C, Verheugt FW, de Los Angeles Alonso García M. Report of the European Society of Cardiology Cardiovascular Round Table regulatory workshop update of the evaluation of new agents for the treatment of acute coronary syndrome: Executive summary. EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE 2016; 8:745-754. [PMID: 27357206 DOI: 10.1177/2048872616649859] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Regulatory authorities interpret the results of randomized controlled trials according to published principles. The European Medicines Agency (EMA) is planning a revision of the 2000 and 2003 guidance documents on clinical investigation of new medicinal products for the treatment of acute coronary syndrome (ACS) to achieve consistency with current knowledge in the field. This manuscript summarizes the key output from a collaborative workshop, organized by the Cardiovascular Round Table and the European Affairs Committee of the European Society of Cardiology, involving clinicians, academic researchers, trialists, European and US regulators, and pharmaceutical industry researchers. Specific questions in four key areas were selected as priorities for changes in regulatory guidance: patient selection, endpoints, methodologic issues and issues related to the research for novel agents. Patients with ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) should be studied separately for therapies aimed at the specific pathophysiology of either condition, particularly for treatment of the acute phase, but can be studied together for other treatments, especially long-term therapy. Unstable angina patients should be excluded from acute phase ACS trials. In general, cardiovascular death and reinfarction are recommended for primary efficacy endpoints; other endpoints may be considered if specifically relevant for the therapy under study. New agents or interventions should be tested against a background of evidence-based therapy with expanded follow-up for safety assessment. In conclusion, new guidance documents for randomized controlled trials in ACS should consider changes regarding patient and endpoint selection and definitions, and trial designs. Specific requirements for the evaluation of novel pharmacological therapies need further clarification.
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Affiliation(s)
- Héctor Bueno
- Centro Nacional de Investigaciones Cardiovasculares, Spain.,Cardiology Department, Hospital Universitario 12 de Octubre, Spain.,Universidad Complutense de Madrid, Spain
| | - Pieter de Graeff
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, The Netherlands.,Dutch Medicines Evaluation Board, The Netherlands
| | | | - Joseph Emmerich
- Université Paris-Descartes Cochin-Hôtel Dieu Hospital, French National Agency for Medicines and Health Products Safety, France
| | - Keith Aa Fox
- Centre for Cardiovascular Science, University and Royal Infirmary of Edinburgh, UK
| | | | | | | | | | | | | | | | - Alar Irs
- Department of Cardiology, University of Tartu, Estonia.,Estonian State Agency of Medicines, Estonia
| | | | - Stefan K James
- Department of Medical Sciences, Uppsala University, Sweden
| | - Hugo A Katus
- Medizinische Klinik, Universitätsklinikum Heidelberg, Germany
| | | | | | - Roxana Mehran
- The Zena and Michael A. Wiener Cardiovascular Institute, USA
| | | | - Krishna Prasad
- Medicines and Healthcare Products Regulatory Agency, UK.,St Thomas Hospital, University of London, UK
| | - Marco Roffi
- Department of Cardiology, University Hospital, Switzerland
| | - Giuseppe Mc Rosano
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), San Raffaele Hospital Roma, Italy.,Cardiovascular and Cell Sciences Institute, University of London, UK
| | | | - Peter R Sinnaeve
- Department of Cardiovascular Sciencies, University of Leuven, Belgium
| | | | | | - Frans Van de Werf
- Department of Cardiovascular Sciencies, University of Leuven, Belgium
| | - Claire Varin
- Institut de Recherches Internationales Servier, France
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Kytö V, Sipilä J, Rautava P. Gender-specific and age-specific differences in unstable angina pectoris admissions: a population-based registry study in Finland. BMJ Open 2015; 5:e009025. [PMID: 26474941 PMCID: PMC4611570 DOI: 10.1136/bmjopen-2015-009025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To evaluate gender-specific and age-specific differences in the occurrence of unstable angina pectoris (UAP) caused admissions. DESIGN Population-based retrospective registry study in Finland. PARTICIPANTS All consecutive patients aged ≥30 years hospitalised with a primary diagnosis of UAP in 22 hospitals with a coronary catheterisation laboratory during 5/2000-10/2009. PRIMARY OUTCOME MEASURES Gender-specific and age-specific differences and trends in occurrence of UAP admissions. RESULTS The study period included 27 282 admissions caused primarily by UAP. Of these, 61.9% occurred to men and 38.1% to women with age-adjusted relative risk (RR) of 1.85 (CI 1.61 to 2.14) for the male gender (p<0.0001). The standardised incidence rate of UAP during the whole study was 92.8 (CI 91.8 to 93.9)/100,000 person-years. The incidence rate increased gradually from 1.3 in the population aged 30-34 years to 268.0/100,000 in the population aged 75-84 years. Men had a 2.4-fold risk for UAP admission compared with women in the general population (incidence rate ratio 2.39; CI 2.24 to 2.56; p<0.0001). Gender difference was present in all age groups. UAP caused 22.4% of acute coronary syndrome admissions and 4.7% of all cardiovascular admissions. UAP was more likely to be the cause of cardiovascular admission in male patients (RR=1.25; CI 1.21 to 1.30, p<0.0001 compared with female patients), but there was no gender difference in acute coronary syndrome admissions. The incidence rate of UAP hospitalisations in the general population declined by an estimated 8% per study-year (p<0.0001). Declining incidence was evident regardless of gender and age. CONCLUSIONS Men have a 2.4-fold overall RR for UAP admission compared to women in the general population. Admissions due to UAP have a declining incidence trend across the adult Finnish population.
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Affiliation(s)
- Ville Kytö
- Heart Center, Turku University Hospital, Turku, Finland
- Department of Medicine, Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Jussi Sipilä
- Division of Clinical Neurosciences, Neurology, Turku University Hospital, Turku, Finland
- Department of Neurology, University of Turku, Turku, Finland
| | - Päivi Rautava
- Clinical Research Center, Turku University Hospital, Turku, Finland
- Department of Public Health, University of Turku, Turku, Finland
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11
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Affiliation(s)
- Gautam R. Shroff
- From Hennepin County Medical Center and University of Minnesota, Minneapolis, Minnesota
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12
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Medicare claims for myocardial infarction as primary vs. secondary diagnosis. Int J Cardiol 2014; 182:412-3. [PMID: 25596467 DOI: 10.1016/j.ijcard.2014.12.141] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 12/29/2014] [Indexed: 11/20/2022]
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