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Mahmoud HT, Berton G, Cordiano R, Palmieri R, Merotto D, Menegon F. Heart failure during acute coronary syndrome and the long-term cancer risk: the ABC-9 Study on heart disease. ESC Heart Fail 2024; 11:1389-1399. [PMID: 38376007 PMCID: PMC11098652 DOI: 10.1002/ehf2.14668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 12/10/2023] [Accepted: 12/18/2023] [Indexed: 02/21/2024] Open
Abstract
AIMS A higher risk of cancer among patients with heart failure (HF) has been suggested in recent community-based studies. This study aimed to investigate the impact of HF during hospitalization with acute coronary syndrome (ACS) on the long-term cancer risk. METHODS AND RESULTS The study included 572 patients admitted with ACS to three Italian hospitals, discharged cancer-free, and prospectively followed for 24 years or until death. All but three patients completed the follow-up, which represented 6440 person-years (mean age: 66 ± 12 years; 70% males). Baseline HF was diagnosed in 192 (34%) patients. A total of 129 (23%) patients developed cancer (103 without HF and 26 with HF), and 107 (19%) patients died due to it (81 without HF and 26 with HF). The incidence rates for cancer onset and cancer death were not different according to HF status. Cox regression analysis revealed no association between HF or left ventricular ejection fraction (LVEF) and cancer risk. In addition, no difference in cancer risk was observed among patients with HF with preserved ejection fraction, HF with mildly reduced ejection fraction, and HF with reduced ejection fraction. In competing risk regression analysis, the risk of cancer onset associated with HF was sub-hazard ratio (SHR) 0.47 [95% confidence interval (CI): 0.30-0.72; P = 0.001] and SHR 1.02 (95% CI: 1.01-1.04; P = 0.002) with LVEF. Results were the same in the adjusted model. Yet the fully adjusted model showed an attenuated association between cancer death and HF (SHR: 0.63; 95% CI: 0.37-1.05; P = 0.08) and LVEF (SHR: 1.02; 95% CI: 0.99-1.06; P = 0.08). Consistent results were obtained after using propensity score matching analysis that created 192 pairs. A negative interaction between age and HF and a positive interaction between age and LVEF for cancer risk have also been found. CONCLUSIONS An inverse association between baseline HF and long-term cancer risk has been observed among the ABC Study on heart disease patients who were followed for 24 years after ACS.
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Affiliation(s)
- Heba T. Mahmoud
- The ABC Study on Heart Disease Foundation‐ONLUSConeglianoItaly
- Department of CardiologyMinia UniversityMiniaEgypt
| | - Giuseppe Berton
- The ABC Study on Heart Disease Foundation‐ONLUSConeglianoItaly
| | - Rocco Cordiano
- The ABC Study on Heart Disease Foundation‐ONLUSConeglianoItaly
- Department of Internal Medicine and CardiologyAdria General HospitalAdriaItaly
| | - Rosa Palmieri
- The ABC Study on Heart Disease Foundation‐ONLUSConeglianoItaly
- Department of Internal Medicine and CardiologyAdria General HospitalAdriaItaly
| | - David Merotto
- The ABC Study on Heart Disease Foundation‐ONLUSConeglianoItaly
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Mahmoud HT, Berton G, Cordiano R, Palmieri R, Petucco S, Bagato F. Microalbuminuria during acute coronary syndrome: Association with 22-year mortality and causes of death. The ABC-8* study on heart disease. (*ABC is an acronym for Adria, Bassano, Conegliano, and Padova Hospitals). Int J Cardiol 2023; 374:100-107. [PMID: 36535560 DOI: 10.1016/j.ijcard.2022.12.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 11/28/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Microalbuminuria is associated with adverse outcomes in acute coronary syndrome (ACS) patients. METHODS To evaluate the very long-term association between Microalbuminuria and the overall mortality and causes of death in this clinical setting, we prospectively studied 579 unselected ACS patients admitted to three hospitals. The baseline albumin-to-creatinine ratio (ACR) was measured on days 1, 3, and 7 in 24-h urine samples. Patients were followed for 22 years or until death. RESULTS Virtually all patients completed follow-up; 449(78%) had died: 41% due to non-sudden cardiac death (non-SCD), 19% sudden cardiac death (SCD), 40% due to non-cardiac (non-CD) death. Using unadjusted Cox regression analysis, ACR was a significant predictor of all-cause mortality (hazard ratio [HR] 1.26;95%confidence interval [CI] 1.22-1.31; p˂0.0001) and the three causes of death (HR 1.40;95%CI 1.32-1.48; p˂0.0001), (HR 1.22;95%CI 1.12-1.32; p˂0.0001) and (HR 1.16;95%CI 1.09-1.23; p˂0.0001) for non-SCD, SCD and non-CD respectively. Using a fully adjusted model, ACR was a significant independent predictor of all-cause mortality (HR 1.12; 95%CI 1.08-1.16; p˂0.0001) and only non-SCD (HR 1.21; 95%CI 1.14-1.29; p˂0.0001). There was a positive interaction between ACR level and history of AMI (HR 1.15; 95%CI 1.03-1.29; p = 0.01) and the presence of heart failure at admission (HR 1.11; 95%CI 1.01-1.24; p = 0.04), and negative interaction with higher than median LVEF (HR 0.89; 95%CI 0.80-0.99; p = 0.03) for all-cause mortality at the multivariable level. CONCLUSION Based on the present analysis, baseline urinary albumin excretion during ACS is a strong independent predictor of the very long-term mortality risk, chiefly due to non-sudden cardiac death.
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Affiliation(s)
- Heba T Mahmoud
- The ABC Heart Disease Foundation-ONLUS, Conegliano, Italy; Department of Cardiology, Minia University, Minia, Egypt
| | - Giuseppe Berton
- The ABC Heart Disease Foundation-ONLUS, Conegliano, Italy; Department of Cardiology, Conegliano General Hospital, Conegliano, Italy.
| | - Rocco Cordiano
- The ABC Heart Disease Foundation-ONLUS, Conegliano, Italy; Department of Internal Medicine and Cardiology, Adria General Hospital, Adria, Italy
| | - Rosa Palmieri
- The ABC Heart Disease Foundation-ONLUS, Conegliano, Italy; Department of Internal Medicine and Cardiology, Adria General Hospital, Adria, Italy
| | - Stefania Petucco
- The ABC Heart Disease Foundation-ONLUS, Conegliano, Italy; Local Social Health Unit 7 (ULSS7), Vicenza, Italy
| | - Francnesco Bagato
- The ABC Heart Disease Foundation-ONLUS, Conegliano, Italy; Department of Cardiology, Conegliano General Hospital, Conegliano, Italy
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Mahmoud HT, Berton G, Cordiano R, Palmieri R, Nardi T, Abdel-Wahab MA, Cavuto F. Differences in Cancer Death Risk Long After ACS Among Selected Urban and Rural Areas in North Italy: The ABC-7a Study on Heart Disease. Front Oncol 2021; 11:731249. [PMID: 34722272 PMCID: PMC8551712 DOI: 10.3389/fonc.2021.731249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 09/17/2021] [Indexed: 11/13/2022] Open
Abstract
Background An increased risk of cancer death has been demonstrated for patients diagnosed with acute coronary syndrome (ACS). We are investigating possible geographic risk disparities. Methods This prospective study included 541 ACS patients who were admitted to hospitals and discharged alive in three provinces of Italy’s Veneto region. The patients were classified as residing in urban or rural areas in each province. Results With 3 exceptions, all patients completed the 22-year follow-up or were followed until death. Urban (46%) and rural (54%) residents shared most of their baseline demographic and clinical characteristics. Pre-existing malignancy was noted in 15 patients, whereas 106 patients developed cancer during the follow-up period, which represented 6232 person-years. No difference in the cancer death risk was found between the urban and rural areas or between southern and northern provinces (hazard ratio [HR] 1.1; 95% confidence interval [CI] 0.7–1.7; p = 0.59 and HR 1.1; 95% CI 0.9–1.4; p = 0.29, respectively) according to the unadjusted Cox regression analysis. Geographic areas, however, showed a strong positive interaction, with risk increasing from the urban to rural areas from southern to northern provinces (HR 1.9; 95% CI 1.1–3.0; p = 0.01). The fully adjusted Cox regression and Fine-Gray competing risk regression models provided similar results. Interestingly, these results persisted, and even strengthened, after exclusion of the 22 patients who developed malignancy and survived to the end of follow-up. We did not observe an urban/rural difference in non-neoplastic death risk or a significant interaction between the geographic areas. Conclusion Our analysis reveals that the cancer death risk among unselected ACS patients in Italy’s Veneto region significantly differs by geography. The northern rural area has the highest risk. These results highlight the importance of implementing a preventive policy based on area-specific knowledge.
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Affiliation(s)
- Heba T Mahmoud
- The ABC Heart Disease Foundation-Organizzazione Non Lucrativa di Utilità Sociale (ONLUS), Conegliano, Italy
| | - Giuseppe Berton
- The ABC Heart Disease Foundation-Organizzazione Non Lucrativa di Utilità Sociale (ONLUS), Conegliano, Italy.,Department of Cardiology, Conegliano General Hospital, Conegliano, Italy
| | - Rocco Cordiano
- The ABC Heart Disease Foundation-Organizzazione Non Lucrativa di Utilità Sociale (ONLUS), Conegliano, Italy.,Department of Internal Medicine and Cardiology, Adria General Hospital, Adria, Italy
| | - Rosa Palmieri
- The ABC Heart Disease Foundation-Organizzazione Non Lucrativa di Utilità Sociale (ONLUS), Conegliano, Italy.,Department of Internal Medicine and Cardiology, Adria General Hospital, Adria, Italy
| | - Tobia Nardi
- The ABC Heart Disease Foundation-Organizzazione Non Lucrativa di Utilità Sociale (ONLUS), Conegliano, Italy
| | | | - Fiorella Cavuto
- The ABC Heart Disease Foundation-Organizzazione Non Lucrativa di Utilità Sociale (ONLUS), Conegliano, Italy.,Department of Cardiology, Bassano del Grappa General Hospital, Bassano del Grappa, Italy
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Berton G, Mahmoud HT, Palmieri R, Cavuto F, Cordiano R, Lorenzon E, Bagato F. Risk of malignancy long after acute coronary syndrome in selected urban and rural areas and comparison with smoking risk: the ABC-7* study on Heart Disease. CARDIO-ONCOLOGY (LONDON, ENGLAND) 2021; 7:9. [PMID: 33627190 PMCID: PMC7903679 DOI: 10.1186/s40959-021-00094-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 02/07/2021] [Indexed: 11/12/2022]
Abstract
Background Increased cancer risk has been reported in patients with acute coronary syndrome (ACS). Objectives To investigate geographic differences in risk malignancy long after ACS. Methods We enrolled 586 ACS patients admitted to hospitals in three provinces in the Veneto region of Italy in this prospective study. Patient’s residency was classified into three urban and three nearby rural areas. Results All (except for 3) patients completed the follow-up (22 years or death) and 54 % were living in rural areas. Sixteen patients had pre-existing malignancy, and 106 developed the disease during follow-up. Cancer prevalence was 17 % and 24 % (p = 0.05) and incidence of malignancy was 16 and 21/1000 person-years for urban and rural areas, respectively. In unadjusted logistic regression analysis, cancer risk increased from urban to rural areas (odds ratio [OR] 3.4;95 % confidence interval [CI] 1.7–7.1; p = 0.001), with little change from north to south provinces (OR 1.5;95 % CI 1.0-2.2; p = 0.06). Yet, we found a strong positive interaction between urban-rural areas and provinces (OR 2.1;95 % CI 1.2–3.5; p = 0.003). These results kept true in the fully adjusted model. Unadjusted Cox regression analysis revealed increasing hazards ratios (HRs) for malignancy onset from urban to rural areas (HR 3.0;95 % CI 1.5–6.2; p = 0.02), but not among provinces (HR 1.3;95 % CI 1.0–2.0; p = 0.14). Also, we found a strong positive interaction between geographic areas (HR 2.1;95 % CI 1.3–3.5; p = 0.002), even with a fully adjusted model. Conclusions The results in unselected real-world patients demonstrate a significant geographic difference in malignancy risk in ACS patients, with the highest risk in the north-rural area.
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Affiliation(s)
- Giuseppe Berton
- Department of Cardiology, Conegliano General Hospital, Via Brigata Bisagno, TV, 31015, Conegliano, Italy. .,The ABC Heart Disease Foundation-ONLUS, Conegliano, Italy.
| | - Heba T Mahmoud
- The ABC Heart Disease Foundation-ONLUS, Conegliano, Italy
| | - Rosa Palmieri
- The ABC Heart Disease Foundation-ONLUS, Conegliano, Italy.,Department of Internal Medicine and Cardiology, Adria General Hospital, Adria, Italy
| | - Fiorella Cavuto
- The ABC Heart Disease Foundation-ONLUS, Conegliano, Italy.,Department of Cardiology, Bassano del Grappa General Hospital, Bassano del Grappa, Italy
| | - Rocco Cordiano
- The ABC Heart Disease Foundation-ONLUS, Conegliano, Italy.,Department of Internal Medicine and Cardiology, Adria General Hospital, Adria, Italy
| | | | - Francesco Bagato
- The ABC Heart Disease Foundation-ONLUS, Conegliano, Italy.,Department of Cardiology, Feltre General Hospital, Feltre, Italy
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Berton G, Cordiano R, Mahmoud HT, Bagato F, Cavuto F, Pasquinucci M. Plasma lipid levels during ACS: Association with 20-year mortality: The ABC-5* Study on Heart Disease. Eur J Prev Cardiol 2020; 27:2176-2179. [DOI: 10.1177/2047487319873061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Giuseppe Berton
- Department of Cardiology, Conegliano General Hospital, Italy
- ABC Study on Heart Disease Foundation ONLUS, Conegliano, Italy
| | - Rocco Cordiano
- ABC Study on Heart Disease Foundation ONLUS, Conegliano, Italy
- Department of Internal Medicine and Cardiology, Adria General Hospital, Italy
| | - Heba T Mahmoud
- Department of Cardiology, Conegliano General Hospital, Italy
- ABC Study on Heart Disease Foundation ONLUS, Conegliano, Italy
| | - Francesco Bagato
- ABC Study on Heart Disease Foundation ONLUS, Conegliano, Italy
- Department of Internal Medicine and Cardiology, Adria General Hospital, Italy
| | - Fiorella Cavuto
- ABC Study on Heart Disease Foundation ONLUS, Conegliano, Italy
- Department of Cardiology, Bassano del Grappa General Hospital, Italy
| | - Mattia Pasquinucci
- Department of Cardiology, Conegliano General Hospital, Italy
- ABC Study on Heart Disease Foundation ONLUS, Conegliano, Italy
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Berton G, Cordiano R, Mahmoud HT, Palmieri R, Cavuto F, Pasquinucci M. Baseline plasma lipid levels in patients with acute coronary syndrome: Association with 20-year mortality. The ABC-5a* Study on Heart Disease. Int J Clin Pract 2020; 74:e13492. [PMID: 32083393 DOI: 10.1111/ijcp.13492] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 02/13/2020] [Accepted: 02/17/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The relationship between baseline plasma lipid levels during acute coronary syndrome and the outcome has clinical relevance. METHODS To evaluate their long-term prognostic value, we examined 589 patients admitted with acute coronary syndrome at three hospitals. Baseline plasma lipids were assessed on days 1 and 7. Patients were followed for 20 years or until death. RESULTS Virtually, all patients completed follow-up; 437 (74%) had died: 24% from coronary artery disease/heart failure (CAD/HF), 21% sudden cardiac death (SCD), 16% from other cardiovascular causes and 39% had non-cardiac death. The incidence rate (IR) of all-cause mortality was not different among patients with baseline plasma lipids less or greater than the median value. The IR of CAD/HF mortality was not significantly higher among patients with greater than median low-density lipoprotein (LDL) cholesterol and triglyceride (TG) levels. The IR of non-cardiac death tended to be lower among patients with greater than median total cholesterol (TC) and LDL levels. Using three levels of adjusted Cox survival models, baseline plasma lipids had no consistent independent or inverse association with all-cause mortality, even after excluding patients who received statins. Competitive risk survival models for each cause of death revealed that the only hazard of non-cardiac death was consistently higher among patients with less than or equal to median TC and LDL levels. CONCLUSION In the present prospective long-term study, after acute coronary syndrome, baseline plasma lipid levels seem not to be associated with long-term global mortality. Only an independent inverse association between TC and LDL and non-cardiac death has been observed.
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Affiliation(s)
- Giuseppe Berton
- Department of Cardiology, Conegliano General Hospital, Conegliano, Italy
- The ABC Heart Disease Foundation-ONLUS, Conegliano, Italy
| | - Rocco Cordiano
- The ABC Heart Disease Foundation-ONLUS, Conegliano, Italy
- Department of Internal Medicine and Cardiology, Adria General Hospital, Adria, Italy
| | - Heba T Mahmoud
- The ABC Heart Disease Foundation-ONLUS, Conegliano, Italy
| | - Rosa Palmieri
- The ABC Heart Disease Foundation-ONLUS, Conegliano, Italy
- Department of Internal Medicine and Cardiology, Adria General Hospital, Adria, Italy
| | - Fiorella Cavuto
- The ABC Heart Disease Foundation-ONLUS, Conegliano, Italy
- Department of Cardiology, Bassano del Grappa General Hospital, Bassano del Grappa, Italy
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Berton G, Cordiano R, Cavuto F, Bagato F, Mahmoud HT, Pasquinucci M. Association between plasma lipid levels during acute coronary syndrome and long-term malignancy risk. The ABC-4* study on heart disease. BMC Cardiovasc Disord 2019; 19:119. [PMID: 31109285 PMCID: PMC6528357 DOI: 10.1186/s12872-019-1092-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 04/30/2019] [Indexed: 01/02/2023] Open
Abstract
Background Emerging evidence suggests that patients with coronary artery disease carry an increased risk of developing malignancy, with deleterious effects on long-term prognosis. Our aim was to ascertain whether baseline plasma lipid levels during acute coronary syndrome (ACS) are associated with malignancy in long-term. Methods This study included 589 patients admitted with ACS to three centers and discharged alive. Plasma lipid levels were assessed on the first morning after admission. Patients were followed for 17 years or until death. Results Five hundred seventy-one patients were free from malignancy at enrollment, of them 99 (17.3%) developed the disease during follow-up and 75 (13.1%) died due to it. Compared to patients without malignancy, those with malignancy showed lower plasma levels of total cholesterol (TC), low-density lipoprotein (LDL), and triglycerides (TG). The groups showed similar statin use rates at any time in follow-up. The incidence rate of neoplasia and neoplastic mortality was higher in patients with baseline TC or LDL values ≤ median; they showed 85 and 72% increased incidence rate of developing malignancy and 133 and 122% increased incidence rate of neoplastic death respectively. No differences were observed relative to HDL and TG levels. In survival analysis using Cox regression with parsimonious models, patients with baseline TC or LDL values > median, respectively, showed risks of 0.6(95% CI 0.4–0.9; p = 0.01) and 0.6(95%CI 0.4–0.9; p = 0.02) for malignancy onset, and 0.5(95% CI 0.3–0.8; p = 0.005) and 0.5(95% CI 0.3–0.8; p = 0.004) for neoplastic death. Similar results were obtained using competitive risk analysis with parsimonious models. Conclusions This long-term prospective study of an unselected real-world patient sample showed that neoplasia onset and mortality are independently associated with low plasma TC and LDL levels at admission for ACS.
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Affiliation(s)
- Giuseppe Berton
- Department of Cardiology, Conegliano General Hospital, Via Brigata Bisagno, 31015, Conegliano, TV, Italy. .,ABC Study on Heart Disease Foundation ONLUS, Conegliano, Italy.
| | - Rocco Cordiano
- ABC Study on Heart Disease Foundation ONLUS, Conegliano, Italy.,Department of Internal Medicine and Cardiology, Adria General Hospital, Adria, Italy
| | - Fiorella Cavuto
- ABC Study on Heart Disease Foundation ONLUS, Conegliano, Italy.,Department of Cardiology, Bassano del Grappa General Hospital, Bassano del Grappa, Italy
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Riccio C, Gulizia MM, Colivicchi F, Di Lenarda A, Musumeci G, Faggiano PM, Abrignani MG, Rossini R, Fattirolli F, Valente S, Mureddu GF, Temporelli PL, Olivari Z, Amico AF, Casolo G, Fresco C, Menozzi A, Nardi F. ANMCO/GICR-IACPR/SICI-GISE Consensus Document: the clinical management of chronic ischaemic cardiomyopathy. Eur Heart J Suppl 2017; 19:D163-D189. [PMID: 28533729 PMCID: PMC5421493 DOI: 10.1093/eurheartj/sux021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Stable coronary artery disease (CAD) is a clinical entity of great epidemiological importance. It is becoming increasingly common due to the longer life expectancy, being strictly related to age and to advances in diagnostic techniques and pharmacological and non-pharmacological interventions. Stable CAD encompasses a variety of clinical and anatomic presentations, making the identification of its clinical and anatomical features challenging. Therapeutic interventions should be defined on an individual basis according to the patient's risk profile. To this aim, management flow charts have been reviewed based on sustainability and appropriateness derived from recent evidence. Special emphasis has been placed on non-pharmacological interventions, stressing the importance of lifestyle changes, including smoking cessation, regular physical activity, and diet. Adherence to therapy as an emerging risk factor is also discussed.
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Affiliation(s)
- Carmine Riccio
- Cardiovascular Science Department, A.O. Sant’Anna e San Sebastiano, Via Palasciano, 1 81100 Caserta, Italy
| | - Michele Massimo Gulizia
- Department of Cardiology, Ospedale Garibaldi-Nesima, Azienda di Rilievo Nazionale e Alta Specializzazione “Garibaldi”, Catania, Italy
| | - Furio Colivicchi
- CCU Unit, Department of Cardiology, Presidio Ospedaliero San Filippo Neri, Rome, Italy
| | - Andrea Di Lenarda
- Cardiovascular Center, Azienda Sanitaria Universitaria Integrata, Trieste, Italy
| | | | | | | | - Roberta Rossini
- Cardiology Department, A.O. Santa Croce e Carle, Cuneo, Italy
| | | | - Serafina Valente
- Intensive Integrated Cardiology Department, AOU Careggi, Florence, Italy
| | - Gian Francesco Mureddu
- Cardiology and Cardiac Rehabilitation Department, A.O. San Giovanni-Addolorata, Rome, Italy
| | | | - Zoran Olivari
- Department of Cardiology, Ospedale Ca’ Foncello, Treviso, Italy
| | | | - Giancarlo Casolo
- Cardiology Unit, Nuovo Ospedale Versilia, Lido di Camaiore, Lucca, Italy
| | - Claudio Fresco
- Cardiology Unit, A.O.U. Santa Maria della Misericordia, Udine, Italy
| | - Alberto Menozzi
- Cardiology Unit, Azienda Ospedaliera Universitaria di Parma, Parma, Italy
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Heart failure in women and men during acute coronary syndrome and long-term cardiovascular mortality (the ABC-3* Study on Heart Disease) (*Adria, Bassano, Conegliano, and Padova Hospitals). Int J Cardiol 2016; 220:538-43. [DOI: 10.1016/j.ijcard.2016.06.085] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 06/07/2016] [Accepted: 06/21/2016] [Indexed: 11/23/2022]
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Tisminetzky M, Gurwitz J, Chen HY, Erskine N, Yarzebski J, Gore J, Lessard D, Goldberg R. Identification and Characteristics of Low-Risk Survivors of an Acute Myocardial Infarction. Am J Cardiol 2016; 117:1552-1557. [PMID: 27013386 DOI: 10.1016/j.amjcard.2016.02.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 02/16/2016] [Accepted: 02/16/2016] [Indexed: 11/28/2022]
Abstract
There are limited contemporary data available describing the characteristics of patients who neither died nor were readmitted to the hospital during the first year after hospital discharge for an acute myocardial infarction (AMI) in comparison with those who died and/or were readmitted to the hospital during this high-risk period. Residents of the Worcester, Massachusetts, metropolitan area discharged after an AMI from 3 central Massachusetts hospitals on a biennial basis from 2001 to 2011 comprised the study population. The average age of this population (n = 4,268) was 69 years, 62% were men, and 92% were white. From 2001 to 2011, 43.5% of patients were classified as low-risk survivors of an AMI, 12.3% died, and 44.2% did not die but had at least 1 rehospitalization during the subsequent year. The proportion of low-risk survivors increased from 42.6% to 46.4%, whereas the proportion of those who died within a year after hospital discharge decreased from 14.3% to 10.5%, respectively, during the years under study. After adjusting for several patient characteristics, younger (≤65 years) persons, men, those who were married, those who did not present with multimorbidities, and patients who did not develop in-hospital clinical complications were more likely to be classified as a low-risk AMI survivor. Identifying low-risk survivors of an AMI may help health care providers to focus more intensive efforts and interventions on those at higher risk for dying and/or being readmitted to the hospital during the postdischarge transition period after an AMI.
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