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Geremew GW, Alemayehu TT, Bekalu AF, Mengistu ME, Anberbr SS, Getahun AD, Fentahun S, Tadesse G, Wassie YA. Optimal medical therapy, clinical outcome and its predictors in patients with acute coronary syndrome after discharge with secondary prevention medications at University of Gondar Comprehensive Specialized Hospital, North West Ethiopia, 2023: A retrospective follow-up study. BMC Cardiovasc Disord 2024; 24:533. [PMID: 39363265 PMCID: PMC11448055 DOI: 10.1186/s12872-024-04199-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Accepted: 09/16/2024] [Indexed: 10/05/2024] Open
Abstract
BACKGROUND The life-threatening diseases known as ACS (acute coronary syndrome) continue to produce considerable rates of morbidity and mortality despite breakthroughs in therapy. The study determined clinical outcome and its predictors in patients at the University of Gondar Comprehensive and Specialized Hospital (UOGCSH), North West Ethiopia. DESIGN, SETTING, AND PARTICIPANTS A retrospective cohort study design was employed at UOGCSH from January 31, 2018 to February 1, 2023. The hospital used a systematic random sampling procedure to select study participants from the medical records of patients in chronic cardiac follow-up clinics. MAIN OUTCOME MEASURES Exposures were optimal medical therapy (OMT) versus non-optimal medical therapy collected from May to August 2023. Descriptive and analytical statistics were employed to compare study groups. A binary logistic regression model was employed to identify candidate variables for further analysis. Cox's proportional hazard model and log-rank test were employed, with a P-value < 0.05 used to evaluate statistical significance. A five-year all-cause mortality after discharge estimate was displayed by using Kaplan-Meier curves. RESULTS Among 422 patients with ACS [mean age, 61.56 (SD = 9.686) years; 54.7% male], of whom only 59.2% (250) received optimal medical therapy at discharge. Age ≥ 65, atrial fibrillation, chronic kidney diseases, and cardiogenic shock were negative independent predictors of optimal medical therapy. On the other hand, male sex was independently associated with the use of optimal medical therapy. All-cause mortality occurred in 16.6% (n = 70) and major adverse cardiac events occurred in 30.8% (n = 130) of patients with a 95% CI of 0.132-0.205 and 0.264-0.355, respectively. Multivariate analyses indicated that OMT was significantly associated with reduced all-cause mortality (aHR: 0.431, 95% CI: 0.222-0.835; P = 0.013). CONCLUSION This study revealed that the use of preventive OMT in patients discharged with acute coronary syndrome was associated with a reduction in all-cause mortality. However, the use of this OMT is suboptimal.
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Affiliation(s)
- Gebremariam Wulie Geremew
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Tekletsadik Tekleslassie Alemayehu
- Departement of Social and Administrative Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abaynesh Fentahun Bekalu
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melak Erara Mengistu
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Sisay Sitotaw Anberbr
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adane Desta Getahun
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Setegn Fentahun
- Departement of Psychiatry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gebresilassie Tadesse
- Departement of Psychiatry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yilkal Abebaw Wassie
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Zeng Z, Shen Y, Wan L, Yang X, Hu Q, Luo H, He M. Kinesiophobia in patients after cardiac surgery: a scoping review. BMC Cardiovasc Disord 2024; 24:469. [PMID: 39223455 PMCID: PMC11370225 DOI: 10.1186/s12872-024-04140-2] [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: 07/03/2024] [Accepted: 08/21/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND This paper reviews the scope of research on kinesiophobia in patients after cardiac surgery. Further, it reviews the current situation, evaluation tools, risk factors, adverse effects, and intervention methods of kinesiophobia to provide a reference for promoting early rehabilitation of patients after cardiac surgery. METHODS Guided by the scoping methodology, the Web of Science, PubMed, CINAHL, Cochrane Library, China Biomedical Literature Database, VIP Database, Wanfang Database, CNKI, and other databases were searched from database inception until July 31, 2024. The studies obtained were screened, summarised and systematically analysed by two researchers. RESULTS Eighteen studies (16 cross-sectional studies, one qualitative study, and one randomised controlled trial) were included. The incidence of kinesiophobia in patients after cardiac surgery was 39.20-82.57%, and the Tampa Scale for Kinesiophobia Heart (TSK-SV Heart) was used to evaluate this incidence. The influencing factors of kinesiophobia in patients after cardiac surgery included demographic characteristics, pain severity, frailty, exercise self-efficacy, disease-related factors, and psychosocial factors. Kinesiophobia led to adverse health outcomes such as reduced recovery, prolonged hospital stays, and decreased quality of life in patients after cardiac surgery, and there were few studies on intervention methods for postoperative kinesiophobia. CONCLUSION The kinesiophobia assessment tools suitable for patients after cardiac surgery should be improved, and intervention methods to promote the early recovery of patients after major clinical surgery and those with difficult and critical diseases should be actively researched.
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Affiliation(s)
- Zhi Zeng
- School of Nursing, North Sichuan Medical College, Nanchong, Sichuan, China
- Affiliated with the School of Medicine, Mianyang Central Hospital, University of Electronic Science and Technology of China, Mianyang, Sichuan, China
| | - Yuqi Shen
- Affiliated with the School of Medicine, Mianyang Central Hospital, University of Electronic Science and Technology of China, Mianyang, Sichuan, China
| | - Li Wan
- Affiliated with the School of Medicine, Mianyang Central Hospital, University of Electronic Science and Technology of China, Mianyang, Sichuan, China
| | - Xiuru Yang
- Affiliated with the School of Medicine, Mianyang Central Hospital, University of Electronic Science and Technology of China, Mianyang, Sichuan, China
| | - Qin Hu
- Affiliated with the School of Medicine, Mianyang Central Hospital, University of Electronic Science and Technology of China, Mianyang, Sichuan, China
| | - Huaili Luo
- Affiliated with the School of Medicine, Mianyang Central Hospital, University of Electronic Science and Technology of China, Mianyang, Sichuan, China
| | - Mei He
- Affiliated with the School of Medicine, Mianyang Central Hospital, University of Electronic Science and Technology of China, Mianyang, Sichuan, China.
- Department of Nursing, Affiliated with the School of Medicine, Mianyang Central Hospital, University of Electronic Science and Technology of China, No.12 Changjia Alley, Jingzhong Street, Fucheng District, Mianyang, Sichuan, 621000, China.
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Yuksel Y, Yildiz C, Kose S. Assessment of Predictive Value of SYNTAX-II Score for Adverse Cardiac Events and Clinical Outcomes in Patients With Acute Coronary Syndrome. Angiology 2024; 75:754-763. [PMID: 37295413 DOI: 10.1177/00033197231181958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Prognostic information is important for the management of acute coronary syndrome (ACS). Our aim was to evaluate Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) score-II (SSII) for predicting contrast induced nephropathy (CIN) and one-year major adverse cardiac events (MACE) in ACS patients. Coronary angiographic recordings of 1304 ACS patients were retrospectively examined. Predictive values of SYNTAX score (SS), SSII-percutaneous coronary intervention (SSII-PCI), SSII-coronary artery bypass graft (SSII-CABG) scores for CIN and MACE were assessed. Combination of CIN and MACE ratios constituted primary composite end-point. Patients with SSII-PCI scores >32.55 were compared with patients with lower scores. All of the three scoring systems predicted the composite primary end-point [SS: Area under the curve (AUC): .718, P < .001 (95% CI: .689-.747), SSII-PCI: AUC: .824, P < .001 (95% CI: .800-.849), SSII-CABG: AUC: .778, P < .001 (95% CI: .751-.805)]. Comparison of AUC of receiver operating characteristic curves showed that SSII-PCI score had better predictive value than that of SS and SSII-CABG scores. In multivariate analysis, the only predictor of the primary composite end-point was SSII-PCI score (odds ratio: 1.126, 95% CI: 1.107-1.146, P < .001). SSII-PCI score was a valuable tool for prediction of shock, CABG, myocardial infarction, stent thrombosis, development of CIN and one-year mortality.
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Affiliation(s)
- Yasin Yuksel
- Department of Cardiology, University of Health Sciences, Istanbul Training and Education Hospital, Istanbul, Turkey
| | - Cennet Yildiz
- Department of Cardiology, University of Health Sciences Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey
| | - Sennur Kose
- Department of Nephrology, University of Health Sciences, Istanbul Training and Education Hospital, Istanbul, Turkey
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Terlecki M, Kocowska-Trytko M, Kurzyca A, Pavlinec C, Zając M, Rusinek J, Lis P, Bednarski A, Wojciechowska W, Stolarz-Skrzypek K, Rajzer M. The sodium-chloride difference: A marker of prognosis in patients with acute myocardial infarction. Eur J Clin Invest 2024; 54:e14157. [PMID: 38226439 DOI: 10.1111/eci.14157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 12/30/2023] [Accepted: 01/01/2024] [Indexed: 01/17/2024]
Abstract
BACKGROUND The difference between serum sodium and chloride ion concentrations (SCD) may be considered as a surrogate of a strong ion difference and may help to identify patients with a worse prognosis. We aimed to assess SCD as an early prognostic marker among patients with myocardial infarction. METHODS Data of 594 consecutive patients with acute myocardial infarction treated with PCI (44.9% STEMI patients; 70.7% males) was analysed for SCD in relation to their 30-day mortality. A restricted cubic spline regression model was used to study the relationship between mortality and SCD. Cox regression models were used to assess the association between SCD and the mortality risk. RESULTS Patients with Killip class ≥3 had lower SCD values in comparison to patients with Killip class ≤2: (32.0 [30.0-34.0] vs. 33.0 [31.0-36.0], p = .006). The overall 30-day mortality was 7.7% (n = 46). There was a significant difference in SCD values between survivors and non-survivors groups of patients (median (IQR): (33.0 [31.0-36.0] vs. 31.5 [28.0-34.0] (mmol/L), p = .002). The restricted cubic splines model confirmed a non-linear association between SCD and mortality. Patients with SCD <30 mmol/L (in comparison to SCD ≥30 mmol/L) had an increased mortality risk (unadjusted HR 2.92, 95% CI 1.59-5.36, p = .001; and an adjusted HR 2.30, 95% CI 1.02-5.19, p = .04). CONCLUSIONS Low SCD on admission is associated with an increased risk of 30-day mortality in patients with acute myocardial infarction treated with PCI and may serve as a useful prognostic marker for these patients.
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Affiliation(s)
- Michał Terlecki
- Department of Interdisciplinary Intensive Care, Jagiellonian University Medical College, Kraków, Poland
| | - Maryla Kocowska-Trytko
- First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Aleksandra Kurzyca
- First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Christopher Pavlinec
- First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Maciej Zając
- First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
- Student's Scientific Group in the 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Jakub Rusinek
- First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
- Student's Scientific Group in the 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Paweł Lis
- First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Adam Bednarski
- First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Wiktoria Wojciechowska
- First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Katarzyna Stolarz-Skrzypek
- First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Marek Rajzer
- First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
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Guo J, Huang Y, Pang L, Zhou Y, Yuan J, Zhou B, Fu M. Association of systemic inflammatory response index with ST segment elevation myocardial infarction and degree of coronary stenosis: a cross-sectional study. BMC Cardiovasc Disord 2024; 24:98. [PMID: 38336634 PMCID: PMC10858502 DOI: 10.1186/s12872-024-03751-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 01/28/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Systemic Inflammatory Response Index (SIRI), a composite inflammatory marker encompassing neutrophils, monocytes, and lymphocytes, has been recognized as a reliable marker of systemic inflammation. This article undertakes an analysis of clinical data from ST-segment Elevation Myocardial Infarction (STEMI) patients, aiming to comprehensively assess the relationship between SIRI, STEMI, and the degree of coronary stenosis. METHODS The study involved 1809 patients diagnosed with STEMI between the years 2020 and 2023. Univariate and multivariate logistic regression analyses were conducted to evaluate the risk factors for STEMI. Receiver operating characteristic (ROC) curves were generated to determine the predictive power of SIRI and neutrophil-to-lymphocyte ratio (NLR). Spearman correlation analysis was performed to assess the correlation between SIRI, NLR, and the Gensini score (GS). RESULTS Multivariate logistic regression analysis showed that the SIRI was the independent risk factor for STEMI (adjusted odds ratio (OR) in the highest quartile = 24.96, 95% confidence interval (CI) = 15.32-40.66, P < 0.001). In addition, there is a high correlation between SIRI and GS (β:28.54, 95% CI: 24.63-32.46, P < 0.001). The ROC curve analysis was performed to evaluate the predictive ability of SIRI and NLR for STEMI patients. The area under the curve (AUC) for SIRI was 0.789. The AUC for NLR was 0.754. Regarding the prediction of STEMI in different gender groups, the AUC for SIRI in the male group was 0.771. The AUC for SIRI in the female group was 0.807. Spearman correlation analysis showed that SIRI exhibited a stronger correlation with GS, while NLR was lower (SIRI: r = 0.350, P < 0.001) (NLR: r = 0.313, P < 0.001). CONCLUSION The study reveals a strong correlation between the SIRI and STEMI as well as the degree of coronary artery stenosis. In comparison to NLR, SIRI shows potential in predicting acute myocardial infarction and the severity of coronary artery stenosis. Additionally, SIRI exhibits a stronger predictive capability for female STEMI patients compared to males.
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Affiliation(s)
- Jiongchao Guo
- Department of Cardiology, The Third Affiliated Hospital of Anhui Medical University (The First People's Hospital of Hefei), Hefei, 230000, Anhui, China
| | - Yating Huang
- Department of Endocrinology, The Third Affiliated Hospital of Anhui Medical University (The First People's Hospital of Hefei), Hefei, 230000, Anhui, China
| | - Lamei Pang
- Department of Endocrinology, Hefei BOE Hospital, Hefei, 230000, Anhui, China
| | - Yuan Zhou
- Department of Cardiology, The Third Affiliated Hospital of Anhui Medical University (The First People's Hospital of Hefei), Hefei, 230000, Anhui, China
| | - Jingjing Yuan
- Department of Cardiology, The Third Affiliated Hospital of Anhui Medical University (The First People's Hospital of Hefei), Hefei, 230000, Anhui, China
| | - Bingfeng Zhou
- Department of Cardiology, Hefei BOE Hospital, Hefei, 230000, Anhui, China.
| | - Minmin Fu
- Department of Cardiology, The Third Affiliated Hospital of Anhui Medical University (The First People's Hospital of Hefei), Hefei, 230000, Anhui, China.
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Chen S, Zhu B, Luo Z, Wang Y, Hu Q, Zhou L. The Fibrosis-5 Index Predicts Major Adverse Cardiovascular Events in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention. Angiology 2024:33197241231051. [PMID: 38293928 DOI: 10.1177/00033197241231051] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
This study aimed to evaluate the fibrosis-5 (FIB-5) index as a marker of liver fibrosis for major adverse cardiovascular events (MACE) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). A total of 406 STEMI patients were enrolled in the study. Over an average follow-up of 27 months, 143 of the patients developed MACE. The patients were subgrouped into tertiles based on the FIB-5 index and Kaplan-Meier survival (MACE-free) curves were plotted, showing statistically significant differences (log-rank test, P < .001). In the adjusted Cox regression model, the hazard ratio (HR) of MACE was 1.95 (95% CI 1.21-3.13; P = .006) in tertile 3 and 0.98 (95% CI 0.97-1.00; P = .013) for per unit increase in the FIB-5 index. The area under the curve (AUC) of the FIB-5 index predicting the occurrence of MACE in STEMI patients after PCI was 0.645 (95% CI 0.590-0.701; P < .001). Low FIB-5 may be a useful predictor of MACE in STEMI patients undergoing PCI.
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Affiliation(s)
- Senjiang Chen
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Bouwei Zhu
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Zan Luo
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yinchao Wang
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Qingqing Hu
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Liang Zhou
- Department of Cardiovascular Medicine, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Harbalıoğlu H, Genç Ö, Alıcı G, Quisi A, Yıldırım A. Impact of HAT 2CH 2 Score on the Development of No-Reflow Phenomenon in Patients With ST-Segment Elevation Myocardial Infarction. Angiology 2024; 75:44-53. [PMID: 37249481 DOI: 10.1177/00033197231171235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The HAT2CH2 score [Hypertension (1 point), Age > 75 years (1 point), Stroke/Transient ischemic attack (2 points), Chronic obstructive pulmonary disease (1 point), and Heart failure (2 points)] was originally developed to predict the occurrence of new-onset atrial fibrillation. The aim of the present study was to examine whether this score could predict the development of no-reflow phenomenon (NR) in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (pPCI). Patients (n = 1552) with STEMI were consecutively enrolled in this single-center retrospective study. The SYNTAX score (SXscore) and HAT2CH2 score were calculated. The presence of thrombolysis in myocardial infarction (TIMI) score ≤2, without significant residual stenosis and mechanical obstruction, indicated the presence of NR. The HAT2CH2 score was significantly higher in the NR (+) group compared with the NR (-) group [2.29 ± 1.43 vs 1.46 ± 1.24, p < .001]. In multivariable logistic regression analysis, the HAT2CH2 score [OR = 1.585, p < .001] and SXscore [OR = 1.028, p = .017] were found to be independent predictors of NR. Receiver operating characteristic curve analysis showed that the HAT2CH2 score with a cutoff value of >2 determined NR, with 50.2% sensitivity and 79.4% specificity (AUC = .669, p < .001). In conclusion, the HAT2CH2 score may facilitate risk stratification in estimating NR in STEMI patients undergoing pPCI.
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Affiliation(s)
- Hazar Harbalıoğlu
- Department of Cardiology, Hatay Iskenderun State Hospital, Hatay, Turkey
| | - Ömer Genç
- Department of Cardiology, Basaksehir Cam & Sakura City Hospital, Istanbul, Turkey
| | - Gökhan Alıcı
- University of Health Sciences, Department of Cardiology, Adana City Training & Research Hospital, Adana, Turkey
| | - Alaa Quisi
- Department of Cardiology, Medline Adana Hospital, Adana, Turkey
| | - Abdullah Yıldırım
- University of Health Sciences, Department of Cardiology, Adana City Training & Research Hospital, Adana, Turkey
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Pan Y, Xu M, Mei Y, Wang Y, Zhang Q. Activities of daily living predict periprocedural myocardial infarction and injury following percutaneous coronary intervention: a cross-sectional study. BMC Cardiovasc Disord 2023; 23:427. [PMID: 37644419 PMCID: PMC10466711 DOI: 10.1186/s12872-023-03468-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/22/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND In recent years, there has been growing interest in exploring the relationship between activities of daily living (ADL) and cardiovascular diseases. This retrospective cross-sectional study aimed to investigate the association of ADL measured by Barthel index (BI) with periprocedural myocardial infarction (PMI) and injury following percutaneous coronary intervention (PCI). METHODS Enrolled patients were stratified into impaired and unimpaired ADL groups according to their BI scores. Logistic regressions were conducted to explore the association of ADL on admission with periprocedural myocardial injury and infarction. Restricted cubic spline (RCS) curve and subgroup analysis were also performed. RESULTS Totally, 16.4% of patients suffered from PMI; the mean age was 65.8 ± 10.4 years old. RCS analysis showed that the morbidity of periprocedural myocardial infarction and injury showed a downward tendency with increasing BI scores. Multivariable logistic regression analysis demonstrated that impaired ADL was an independent risk factor for periprocedural myocardial infarction (OR = 1.190, 95% CI [1.041, 1.360], P = 0.011) and injury (OR = 1.131, 95% CI [1.017, 1.257], P = 0.023). Subgroup analysis showed that the association between ADL and PMI was founded in several subgroups, while the association between ADL and periprocedural myocardial injury was founded only in BMI ≥ 24 kg/m2 subgroup. CONCLUSION Impaired ADL at hospital admission was an independent risk factor for periprocedural myocardial infarction and injury among patients following PCI.
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Affiliation(s)
- Yifan Pan
- Department of Cardiology, Yongkang People's Hospital, Yongkang, Zhejiang, 321300, China
| | - Min Xu
- Department of Cardiology, Yongkang People's Hospital, Yongkang, Zhejiang, 321300, China
| | - Yaosheng Mei
- Department of Cardiology, Yongkang People's Hospital, Yongkang, Zhejiang, 321300, China
| | - Yunxiang Wang
- Department of Cardiology, Yongkang People's Hospital, Yongkang, Zhejiang, 321300, China
| | - Qiongli Zhang
- Department of Cardiology, Yongkang Hospital, Yongkang, Zhejiang, 321300, China.
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Ni WC, Kong ST, Lin K, Huang YH, Li JF, Shi SL, Lu YC, Cheng L, Chen CX, Zhou H. Normal thyroid stimulating hormone is associated with all-cause mortality in patients with acute myocardial infarction after percutaneous coronary intervention. Eur J Med Res 2023; 28:199. [PMID: 37381066 DOI: 10.1186/s40001-023-01149-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/29/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND Circulating thyroid-stimulating hormone (TSH) levels within the normal reference range can affect the cardiovascular system. The present study investigated the prognostic value of normal TSH levels in patients presenting with acute myocardial infarction (AMI) following percutaneous coronary intervention (PCI). METHODS Between January 2013 and July 2019, 1240 patients with AMI and normal thyroid function were enrolled and classified according to TSH tertile. The trial endpoint was all-cause mortality. The integrated discrimination index (IDI) and the net reclassification index (NRI) were used to assess the combined predictive values of the TSH levels and the Global Registry of Acute Coronary Events (GRACE) scores. RESULTS After a median 44.25-month follow-up, 195 individuals died. Even after covariate adjustment by multivariate Cox regression (HR: 1.56; 95% CI 1.08-2.25; P = 0.017), the patients in the third TSH tertile were at the highest risk of all-cause mortality. A subgroup analysis revealed significant interactions between the TSH levels and the GRACE scores (high risk vs. low/medium risk) (P = 0.019). The addition of the TSH levels to the GRACE scores substantially improved the prediction of all-cause mortality, especially for high-risk patients (NRI = 0.239; IDI = 0.044; C-statistic value range 0.649-0.691; all significant). CONCLUSIONS The third TSH tertile is associated with a higher incidence of all-cause mortality than the first TSH tertile in high-risk patients presenting with AMI after PCI.
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Affiliation(s)
- Wei-Cheng Ni
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Shu-Ting Kong
- Department of Cardiology, Jin Hua Municipal Central Hospital, Jinhua, China
| | - Ken Lin
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yu-Heng Huang
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jun-Feng Li
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - San-Ling Shi
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yu-Cheng Lu
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ling Cheng
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chang-Xi Chen
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Hao Zhou
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
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Li C, He K, Yang Y, Li K, Chen M, Wang L, Xu X, Li W. Nomograms Based on Non-High-Density Lipoprotein to Predict Outcomes in Patients with Prior Coronary Artery Bypass Grafting with Acute Coronary Syndrome: A Single-Center Retrospective Study. Ther Clin Risk Manag 2023; 19:15-26. [PMID: 36636454 PMCID: PMC9830084 DOI: 10.2147/tcrm.s389694] [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: 09/20/2022] [Accepted: 12/29/2022] [Indexed: 01/06/2023] Open
Abstract
Introduction Non-high-density-lipoprotein cholesterol (non-HDL-C) is a secondary therapeutic target in cardiovascular diseases and is used for residual risk assessment in patients with coronary artery syndrome (ACS). This study was designed to determine the association between non-HDL-C in patients with prior coronary artery bypass graft (CABG) with ACS and clinical outcomes. Methods We retrospectively analyzed 468 patients with prior CABG with ACS and categorized them into two groups based on the median non-HDL-C level. The primary endpoints were major adverse cardiovascular events (MACEs), including cardiovascular death and recurrent myocardial infarction. Kaplan-Meier curves, Cox proportional-hazard regressions, and restricted cubic splines were used to determine the association between non-HDL-C and MACEs. The discrimination and reclassification of the nomogram based on non-HDL-C were assessed using time-dependent receiver operating characteristic (ROC) curves and net reclassification improvement (NRI). Results During the average follow-up time of 744.5 days, non-HDL-C was independently associated with the occurrence of MACEs (hazard ratio [HR] = 5.01, 95% confidence interval [CI] = 1.65-15.24; p = 0.005) after adjusting for other lipid parameters. The spline curves indicated a linear relationship between non-HDL-C and MACEs (p-nonlinear: 0.863). The time-dependent areas under the ROC curves of prior-CABG-ACS nomograms containing non-HDL regarding MACEs in two consecutive years were 91.7 (95% CI: 85.5-97.9) and 91.5 (95% CI: 87.3-95.7), respectively. The NRI analysis indicated that the prior-CABG-ACS model improved the reclassification ability for 1- and 2-year MACEs (22.4% and 7%, p < 0.05, respectively). Discussion Non-HDL is independently associated with the risk of MACEs in patients with prior CABG with ACS. The prior-CABG-ACS nomogram based on non-HDL-C and five convenient variables generates valid and stable predictions of MACE occurrence.
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Affiliation(s)
- Chuang Li
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Kuizheng He
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Yixing Yang
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Kuibao Li
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Mulei Chen
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Lefeng Wang
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Xiaorong Xu
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Weiming Li
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People’s Republic of China,Correspondence: Weiming Li; Xiaorong Xu, Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chao-Yang Hospital, Capital Medical University, 8# Gong-Ti South Road, Beijing, 10020, People’s Republic of China, Email ;
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Li C, Zhang W, Yang Y, Zhang Q, Li K, Chen M, Wang L, Xia K. Prediction of SYNTAX score II improvement by adding temporal heart rate changes between discharge and first outpatient visit in patients with acute myocardial infarction. BMC Cardiovasc Disord 2022; 22:470. [PMID: 36344932 PMCID: PMC9641850 DOI: 10.1186/s12872-022-02929-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 10/31/2022] [Indexed: 11/10/2022] Open
Abstract
Background The prognostic ability of the temporal changes in resting heart rate (ΔHR) in patients with acute myocardial infarction (AMI) for cardiovascular (CV) mortality and clinical outcomes is rarely examined. This study investigated the predictive value of ΔHR using models with SYNTAX score II (SxS-II) for the long-term prognosis of patients with AMI. Methods Six hundred five AMI patients with vital signs recorded at the first outpatient visit (2–4 weeks after discharge) were retrospectively recruited into this study. The changes between discharge and outpatient resting heart rate (D-O ΔHR) were calculated by subtracting the HR at the first post-discharge visit from the value recorded at discharge. The major adverse cardiovascular and cerebrovascular events (MACCE) include cardiovascular death, recurrent myocardial infarction, revascularization, and nonfatal stroke. The predictive values and reclassification ability of the different models were assessed using a likelihood ratio test, Akaike’s information criteria (AIC), receiver operating characteristic (ROC) curves, net reclassification improvement (NRI), and integrated discrimination improvement (IDI). Results During the follow-up period, a drop-in resting heart rate (RHR) from discharge to first outpatient visit was independently associated with less risk of CV mortality [D-O ΔHR: hazards ratio (HR) = 0.97, 95% CI = 0.96–0.99, P < 0.001] and MACCE (HR = 0.98, 95% CI = 0.97–0.99, p = 0.001). The likelihood test indicated that the combined model of SxS-II and D-O ΔHR yielded the lowest AIC for CV mortality and MACCE (P < 0.001). Moreover, D-O ΔHR alone significantly improved the net reclassification and integrated discrimination of the models containing SxS-II for CV mortality and MACCE (CV mortality: NRI = 0.5600, P = 0.001 and IDI = 0.0759, P = 0.03; MACCE: NRI = 0.2231, P < 0.05 and IDI = 0.0107, P < 0.05). Conclusions The change in D-O ΔHR was an independent predictor of long-term CV mortality and MACCE. The D-O ΔHR combined with SxS-II could significantly improve its predictive probability.
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Liu Y, Zhang C, Jiang L, Xu L, Tian J, Zhao X, Feng X, Wang D, Zhang Y, Sun K, Xu J, Liu R, Xu B, Zhao W, Hui R, Gao R, Gao Z, Song L, Yuan J. Relationship Between High-Sensitivity C-Reactive Protein and Long-Term Outcomes in Elderly Patients With 3-Vessel Disease. Angiology 2022; 73:60-67. [PMID: 34109809 DOI: 10.1177/00033197211021195] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The prognostic value of high-sensitivity C-reactive protein (hsCRP) in complex coronary artery disease has not been fully established. We aimed to determine the association between hsCRP and long-term outcomes in elderly patients with 3-vessel disease (TVD). From April 2004 to February 2011, 3069 patients aged ≥65 years with TVD were consecutively enrolled and received medical treatment alone, percutaneous coronary intervention, or coronary artery bypass grafting. The patients were divided into 2 groups according to their hsCRP levels: <3.00 mg/L (62.1%) and ≥3.00 mg/L (37.9%). The mean age was 71 ± 4 years. The high hsCRP group had more risk factors and more frequently received conservative treatment than the low hsCRP group. During a median follow-up period of 6.2 years, elevated hsCRP was significantly associated with increased all-cause death (19.5% vs 29.6%, P < .001), cardiac death (9.4% vs 15.2%, P = .001), and major adverse cardiovascular and cerebrovascular events (34.1% vs 42.5%, P = .001). Multivariable Cox regression analyses revealed that hsCRP was an independent predictor for all of these events. Combining hsCRP with Synergy between PCI with TAXUS and Cardiac Surgery score II further improved the predictive power of the score. The relationship between hsCRP and mortality was relatively consistent across subgroups. Overall, hsCRP could prove useful for risk prediction in elderly patients.
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Affiliation(s)
- Yue Liu
- 34736Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Ce Zhang
- 34736Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Lin Jiang
- 34736Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Lianjun Xu
- 34736Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Jian Tian
- 34736Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Xueyan Zhao
- 34736Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Xinxing Feng
- 34736Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Dong Wang
- 34736Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Yin Zhang
- 34736Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Kai Sun
- 34736Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Jingjing Xu
- 34736Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Ru Liu
- 34736Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Bo Xu
- 34736Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Wei Zhao
- 34736Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Rutai Hui
- 34736Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Runlin Gao
- 34736Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Zhan Gao
- 34736Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Lei Song
- 34736Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Jinqing Yuan
- 34736Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
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Kong F, Xiang L, Wu Y, Tong G. Evaluation of the Prognostic Role of the Wall Motion Score Index and the SYNTAX Score II in Patients with Acute Coronary Syndrome Following Percutaneous Coronary Intervention by Evaluation of Major Adverse Cardiovascular Events at 12-Month Follow-Up. Med Sci Monit 2021; 27:e932652. [PMID: 34741003 PMCID: PMC8579602 DOI: 10.12659/msm.932652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background This study aimed to evaluate the wall motion score (WMS) index and the SYNTAX score II (SSII) in patients with acute coronary syndrome (ACS) following percutaneous coronary intervention (PCI) by evaluation of major adverse cardiovascular events (MACEs) at the 12-month follow-up at a single center. Material/Methods An observational study of 430 patients with ACS undergoing PCI at the Second Affiliated Hospital of Soochow University over a 1-year period was performed. Baseline data including WMS and SSII were recorded and compared with the rates of MACEs in the study group. WMS and SSII were stratified by the tercile from low to high. Results Both WMS and SSII were associated with the rates of MACEs (P<0.001 and P=0.003, respectively). The incidence of MACEs was positively correlated with terciles of the WMS and SSII groups (3.7% vs 1.6% vs 7.0% [P<0.001] and 2.6% vs 5.8% vs 11.6% [P<0.001], lowest to highest, respectively). Logistic regression analyses identified combined predictors for 12-month outcome, including WMS and SSII. The use of a model combining both scores yielded a higher predictive value (area under the curve [AUC]=0.78; 95% confidence interval [CI], 0.733–0.835; P<0.001) than the use of either score alone. Using WMSs alone, the AUC was 0.73 (95% CI, 0.660–0.793; P<0.001). Using SSII alone, the AUC was 0.71 (95% CI, 0.649–0.769; P<0.001). Conclusions This study showed that the combined methods of the WMS index and the SSII were predictive factors of MACEs in patients with ACS following PCI at the 12-month follow-up.
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Affiliation(s)
- Fanyang Kong
- Department of Cardiology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China (mainland)
| | - Li Xiang
- Department of Cardiology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China (mainland)
| | - Yanni Wu
- Department of Cardiology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China (mainland)
| | - Guangming Tong
- Department of Cardiology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China (mainland)
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Li C, Zhang Q, Wang Q, Zhong J, Wang L, Li K, Yang X. Prognostic values of the SYNTAX score II and the erythrocyte sedimentation rate on long-term clinical outcomes in STEMI patients with multivessel disease: a retrospective cohort study. BMC Cardiovasc Disord 2020; 20:213. [PMID: 32375646 PMCID: PMC7204004 DOI: 10.1186/s12872-020-01490-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 04/19/2020] [Indexed: 12/01/2022] Open
Abstract
Background There is a paucity of evidence on the combination of the SYNTAX score II (SSII) and erythrocyte sedimentation rate (ESR) in assessing the long-term prognosis of patients with ST-elevated myocardial infarction (STEMI) and multivessel disease. The objective of this study was to investigate whether the ESR could enhance the predictive value of SSII on the long-term prognosis of STEMI patients. Methods A retrospective cohort study involving 483 STEMI and multivessel disease subjects receiving primary percutaneous coronary intervention was conducted. Major adverse cardiovascular events (MACE) included cardiovascular death, acute heart failure, recurrent myocardial infarction, revascularization, and nonfatal stroke. The predicted values of different models were estimated by a likelihood ratio test, Akaike’s information criteria (AIC), receiver operating characteristic (ROC) curves, net reclassification improvement (NRI), and integrated discrimination improvement (IDI). Results During the follow-up period of up to 52 months, both the SSII and ESR were independently associated with MACE (hazard ratio [HR] = 1.032, p < 0.001; and HR = 1.021, p < 0.001, respectively). The likelihood test indicated that ESR could improve the prognostic model containing SSII (p < 0.001), while the combined model of SSII and ESR attained a lower AIC (p < 0.001). The area under the ROC curve of the combined model containing SSII and ESR increased by 0.05 (p = 0.04) compared to that of the model with SSII alone. The net reclassification and integrated discrimination of the SSII alone model improved significantly with ESR (NRI = 0.0319, p < 0.001; IDI = 0.0334, p < 0.001). Conclusions The prognostic model containing SSII, which is an independent risk factor of MACE, had a significantly enhanced predictive probability with the addition of ESR.
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Affiliation(s)
- Chuang Li
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, 8# Gong-Ti South Road, Beijing, 10020, China
| | - Qian Zhang
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, 8# Gong-Ti South Road, Beijing, 10020, China
| | - Qianhui Wang
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, 8# Gong-Ti South Road, Beijing, 10020, China
| | - Jiuchang Zhong
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, 8# Gong-Ti South Road, Beijing, 10020, China
| | - Lefeng Wang
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, 8# Gong-Ti South Road, Beijing, 10020, China
| | - Kuibao Li
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, 8# Gong-Ti South Road, Beijing, 10020, China.
| | - Xinchun Yang
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, 8# Gong-Ti South Road, Beijing, 10020, China.
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