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New Onset Atrial Fibrillation in STEMI Patients: Main Prognostic Factors and Clinical Outcome. Diagnostics (Basel) 2023; 13:diagnostics13040613. [PMID: 36832101 PMCID: PMC9955053 DOI: 10.3390/diagnostics13040613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 02/11/2023] Open
Abstract
The indications for the treatment of patients with known atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) are clear, while less is available about the management of new-onset AF (NOAF) during ST-segment elevation myocardial infarction (STEMI). The aim of this study is to evaluate mortality and clinical outcome of this high-risk subgroup of patients. We analyzed 1455 consecutive patients undergoing PCI for STEMI. NOAF was detected in 102 subjects, 62.7% males, with a mean age of 74.8 ± 10.6 years. The mean ejection fraction (EF) was 43.5 ± 12.1% and the mean atrial volume was increased (58 ± 20.9 mL). NOAF occurred mainly in the peri-acute phase and had a very variable duration (8.1 ± 12.5 min). During hospitalization, all the patients were treated with enoxaparin, but only 21.6% of them were discharged with long term oral anticoagulation. The majority of patients had a CHA2DS2-VASc score >2 and a HAS-BLED score of 2 or 3. The in-hospital mortality was 14.2%, while the 1-year mortality was 17.2% and long-term mortality 32.1% (median follow-up 1820 days). We identified age as an independent predictor of mortality both at short- and long-term follow-ups, while EF was the only independent predictor for in-hospital mortality and arrhythmia duration for 1-year mortality. At the 1-year follow-up, we recorded three ischemic strokes and no bleeding complications.
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Alıcı G, Genç Ö, Urgun ÖD, Erdoğdu T, Yıldırım A, Quisi A, Kurt İH. The value of PRECISE-DAPT score and lesion complexity for predicting all-cause mortality in patients with NSTEMI. Egypt Heart J 2023; 75:2. [PMID: 36602654 PMCID: PMC9816365 DOI: 10.1186/s43044-023-00329-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 12/30/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND We aimed to evaluate the prognostic effects of stroke risk scores (SRS), SYNTAX score (SX score), and PRECISE-DAPT score on mortality in patients with non-ST-segment elevation myocardial infarction (NSTEMI). Three hundred forty-three patients hospitalized with a diagnosis of NSTEMI and underwent coronary angiography (CAG) between January 1, 2022, and June 1, 2022, were included retrospectively in this single-center study. Patients' demographic, clinical and routine biochemical parameters were recorded. The scores (CHADS2, CHA2DS2-VASc, R2CHA2DS2-VASc, ATRIA, SX score, PRECISE-DAPT) of each patient were calculated. Participants were then divided into two groups by in-hospital status; all-cause mortality (+) and all-cause mortality (-). RESULTS Overall, the mean age was 63.5 ± 11.8 years, of whom 63.3% (n = 217) were male. In-hospital mortality occurred in 31 (9.3%) patients. In the study population, those who died had significantly higher SX (p < 0.001), PRECISE-DAPT (p < 0.001), and ATRIA (p = 0.002) scores than those who survived. In logistic regression analysis, PRECISE-DAPT score [Odds ratio (OR) = 1.063, 95% CI 1.014-1.115; p = 0.012] and SX score [OR: 1.061, 95% CI 1.015-1.109, p = 0.009] were found to be independent predictors of in-hospital all-cause mortality among NSTEMI patients. In ROC analysis, the PRECISE-DAPT score performed better discriminative ability than the SX score in determining in-hospital mortality [Area under the curve = 0.706, 95% CI 0.597-0.814; p < 0.001]. CONCLUSIONS During the hospital stay, both PRECISE-DAPT and SX scores showed better performance than SRS in predicting all-cause mortality among NSTEMI patients undergoing CAG. Aside from their primary purpose, both scores might be useful in determining risk stratification for such patient populations.
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Affiliation(s)
- Gökhan Alıcı
- Department of Cardiology, Adana City Training and Research Hospital, Dr. Mithat Özsan Boulevard, 4522, Yuregir, Adana, Turkey.
| | - Ömer Genç
- Department of Cardiology, Çam and Sakura City Hospital, Istanbul, Turkey
| | | | - Tayfur Erdoğdu
- Department of Cardiology, Adana City Training and Research Hospital, Dr. Mithat Özsan Boulevard, 4522, Yuregir, Adana, Turkey
| | - Abdullah Yıldırım
- Department of Cardiology, Adana City Training and Research Hospital, Dr. Mithat Özsan Boulevard, 4522, Yuregir, Adana, Turkey
| | - Alaa Quisi
- Department of Cardiology, Adana Medline Hospital, Adana, Turkey
| | - İbrahim Halil Kurt
- Department of Cardiology, Adana City Training and Research Hospital, Dr. Mithat Özsan Boulevard, 4522, Yuregir, Adana, Turkey
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Wang Y, Wang S, Zhang J, Zhang M, Zhang H, Gong G, Luo M, Wang T, Mao X. Salusin- β is superior to salusin- α as a marker for evaluating coronary atherosclerosis. J Int Med Res 2020; 48:300060520903868. [PMID: 32054363 PMCID: PMC7111058 DOI: 10.1177/0300060520903868] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objective This study was performed to evaluate the interaction effect of salusin-α and salusin-β on coronary artery injury or stenosis. Methods The salusin-α and salusin-β concentrations were measured by enzyme-linked immunosorbent assay in 256 patients who underwent coronary angiography for chest pain, and coronary artery stenosis was assessed by the SYNTAX scoring system. Multivariate logistic regression was used to analyze the correlation between variables and coronary artery stenosis. The interaction of salusin-α and salusin-β on coronary artery stenosis was further explored by multiple linear regression. Results The model goodness of fit (R) for the interaction effect of salusin-α and salusin-β on coronary artery stenosis was 0.863, and the adjusted R value revealed that the interaction could explain 74.3% of the variation in SYNTAX scores. The F-statistic exceeded F0.05 (3.031485935) and P < 0.001, further showing that salusin-α and salusin-β had a significant interaction effect on coronary artery stenosis. The standard coefficient for salusin-β (0.797) was higher than that for salusin-α (−0.367, indicating an inhibitory effect), showing that salusin-β had a greater effect on coronary artery stenosis. Conclusions Salusin-β, a potential marker for assessing coronary atherosclerosis, was superior to salusin-α, contributing to our understanding of the etiology of coronary artery stenosis.
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Affiliation(s)
- Yuxue Wang
- Department of Laboratory Medicine, Hubei University of Chinese Medicine, Wuhan, China
| | - Songjiao Wang
- Department of Laboratory Medicine, Hubei University of Chinese Medicine, Wuhan, China
| | - Jun Zhang
- Department of Pathology, Ezhou Hospital, People's Hospital, Wuhan University, Ezhou, China
| | - Maona Zhang
- Department of Pathology, Ezhou Hospital, People's Hospital, Wuhan University, Ezhou, China
| | - Hong Zhang
- Department of Pathology, Ezhou Hospital, People's Hospital, Wuhan University, Ezhou, China
| | - Guofu Gong
- Department of Clinical Laboratory, Ezhou Hospital, People's Hospital, Wuhan University, Ezhou, China
| | - Min Luo
- Department of Laboratory Medicine, Hubei University of Chinese Medicine, Wuhan, China
| | - Teng Wang
- Department of Cardiology, Renmin Hospital of Wuhan University & Cardiovascular Research Institute of Wuhan University, Wuhan, China
| | - Xiaolu Mao
- Department of Clinical Laboratory, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Yildirim E, Ermis E, Allahverdiyev S, Ucar H, Cengiz M. Value of Syntax Score II in Prediction of New-Onset Atrial Fibrillation in Patients With NSTE-ACS Undergoing Percutaneous Coronary Intervention. Angiology 2019; 70:860-866. [DOI: 10.1177/0003319719854242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
New-onset atrial fibrillation (NOAF) has been associated with poor outcome in patients with acute coronary syndromes (ACSs). The objective of this study was to investigate the relationship between the development of NOAF and severity of coronary artery disease using the SYNTAX score (SS) and SYNTAX score II (SSII) in patients with non-ST-segment elevation ACS (NSTE-ACS) who were treated with percutaneous coronary intervention (PCI). A total of 662 patients with NSTE-ACS were consecutively enrolled. The incidence of NOAF was 11.4% among the patients with NSTE-ACS. Mean age was significantly higher in NOAF group ( P = .011). White blood cell count, peak troponin I, high sensitivity C-reactive protein, uric acid, left atrial volume index, and ratio between early mitral inflow velocity and mitral annular early diastolic velocity were significantly higher in NOAF group (respectively, P = .024, P = .017, P = .002, P = .009, P = .025, P < .001, and P < .001). The hemoglobin, ejection fraction, and post PCI thrombolysis in myocardial infarction grade <3 were significantly lower in NOAF group ( P = 001, P = .010, P = .038). The SS and SSII were significantly higher in NOAF group (all P < .001). According to the results of multivariate logistic regression analysis, the SSII was correlated with NOAF ( P < .001) in the study groups. We demonstrated that high SSII is significantly associated with NOAF.
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Affiliation(s)
- Erkan Yildirim
- Department of Cardiology, Biruni University Faculty of Medicine, İstanbul, Turkey
| | - Emrah Ermis
- Department of Cardiology, Biruni University Faculty of Medicine, İstanbul, Turkey
| | - Samir Allahverdiyev
- Department of Cardiology, Biruni University Faculty of Medicine, İstanbul, Turkey
| | - Hakan Ucar
- Department of Cardiology, Biruni University Faculty of Medicine, İstanbul, Turkey
| | - Mahir Cengiz
- Department of Internal Medicine, Biruni University Faculty of Medicine, İstanbul, Turkey
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Cirakoglu OF, Aslan AO, Akyuz AR, Kul S, Şahin S, Korkmaz L, Sayın MR. The value of syntax score to predict new-onset atrial fibrillation in patients with acute coronary syndrome. Ann Noninvasive Electrocardiol 2019; 24:e12622. [PMID: 30615236 DOI: 10.1111/anec.12622] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 12/04/2018] [Accepted: 12/16/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND AIM New-onset atrial fibrillation (NOAF) has been associated with poor outcome in patients with acute coronary syndromes (ACS). Also, Syntax score (SS) is a scoring system that is derived from angiographic images and is associated with long-term mortality and major adverse cardiac events. In this study, we aimed to assess the relationship between SS and NOAF with known predictors of atrial fibrillation. METHODS In a prospective, single-center, cross-sectional study, 692 patients who were diagnosed with coronary artery disease for the first time were enrolled consecutively. NOAF was defined as atrial fibrillation, which was documented after hospital admission. SS was calculated by a computer software. Multivariable logistic regression analyzes were used to detect the relationship between variables and NOAF. RESULTS New-onset atrial fibrillation was detected in 82 patients (11.8%). Patients with NOAF had higher SS (22, interquartile range 18.3-25.1, vs. 12, interquartile range 7-19.5, p < 0.001). According to multivariable logistic regression analysis for NOAF, SS were independently and significantly associated (OR, 1.103; 95% confidence interval, 1.047-1.163; p < 0.001). Other independent predictors of NOAF were TIMI flow <3, C reactive protein, left ventricular ejection fraction, left atrial volume index and E/E' ratio. The optimal cut-off value for SS was 18 for the development of NOAF with 82% sensitivity and 68% specificity (area under the curve: 0.795, 95% confidence interval 0.749-0.841, p < 0.001). CONCLUSION Syntax score may be helpful to identify for patients who would develop atrial fibrillation in the setting of ACS.
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Affiliation(s)
- Omer Faruk Cirakoglu
- Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
| | - Ahmet Oğuz Aslan
- Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey.,Department of Cardiology, Akçaabat Haçkalı Baba State Hospital, Trabzon, Turkey
| | - Ali Riza Akyuz
- Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
| | - Selim Kul
- Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
| | - Sinan Şahin
- Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
| | - Levent Korkmaz
- Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
| | - Muhammet Raşit Sayın
- Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
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