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Zhang Q, Gao J, Yin X, Zhang S, Wang Y, Ji H, Zhang X, Song D, Wang J, Chen Y. Risk Prediction Models for Ischemic Cardiovascular Outcomes in Patients with Acute Coronary Syndrome. Rev Cardiovasc Med 2023; 24:106. [PMID: 39076282 PMCID: PMC11273005 DOI: 10.31083/j.rcm2404106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 12/11/2022] [Accepted: 12/23/2022] [Indexed: 07/31/2024] Open
Abstract
Acute coronary syndrome (ACS) has a high incidence of adverse cardiovascular events, even after early invasive treatment. Patients may still have a poor prognosis after discharge. The keys to the long-term survival of patients with ACS include effective treatment in a timely manner and identification of those patients who are at higher risk for long-term adverse events. Therefore, several nations have now devised a range of risk assessment models to provide data for accurately formulating treatment plans for patients with various risk levels following an ACS to prevent short and long-term cardiovascular events. The purpose of this article is to review the risk scores associated with mortality and ischemic events in patients with ACS. By using the clinical risk prediction score, we can accurately and effectively judge the prognosis of patients, so as to take a more reasonable treatment.
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Affiliation(s)
- Qi Zhang
- Department of Emergency Medicine, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Chest Pain Center, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
- Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
| | - Jie Gao
- Department of Emergency Medicine, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Chest Pain Center, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
- Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
| | - Xiaoying Yin
- Department of Emergency Medicine, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Chest Pain Center, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
- Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
| | - Song Zhang
- Department of Emergency Medicine, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Chest Pain Center, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
- Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
| | - Yifan Wang
- Department of Emergency Medicine, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Chest Pain Center, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
- Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
| | - Hongmei Ji
- Department of Emergency Medicine, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Chest Pain Center, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
- Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
| | - Xiao Zhang
- Department of Emergency Medicine, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Chest Pain Center, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
- Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
| | - Dongli Song
- Department of Emergency Medicine, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Chest Pain Center, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
- Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
| | - Jiali Wang
- Department of Emergency Medicine, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Chest Pain Center, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
- Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
| | - Yuguo Chen
- Department of Emergency Medicine, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shandong University, Chest Pain Center, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
- Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
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Chen H, Yu X, Qiu G, Ma L. Predictive value of ACEF score for clinical prognosis of patients with heavily calcified coronary lesions after percutaneous coronary intervention with rotational atherectomy. J Cardiothorac Surg 2022; 17:85. [PMID: 35477470 PMCID: PMC9044582 DOI: 10.1186/s13019-022-01833-7] [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: 06/05/2021] [Accepted: 04/17/2022] [Indexed: 11/23/2022] Open
Abstract
Background To inquiry the predictive value of the age, creatinine, and ejection fraction (ACEF) score for cardiac mortality in patients diagnosed with heavily calcified coronary lesions at 1 year after percutaneous coronary intervention (PCI) with rotational atherectomy (RA). Methods 275 patients with heavily calcified coronary lesions undergoing PCI with RA in the Department of Cardiology of Anhui Provincial Hospital from January 2017 to December 2019 were consecutively recruited. The primary endpoint event was cardiac death at postoperative 1 year. The ROC curve was used to assess ACEF scoring system and predict cardiac mortality. Results In term of ACEF score upon admission, 275 patients were divided into low-to-intermediate risk group (n = 130) with ACEF score < 1.23 and high-risk group (n = 145) with ACEF score ≥ 1.23. The age, gender proportion and left ventricular ejection fraction (LVEF) have a significant difference between the low-to-intermediate risk group and the high-risk group (all P < 0.05). The area under ROC curve for ACEF scoring system to predict cardiac mortality at 1 year after PCI with RA was 0.756 and 0.715, respectively. Conclusions ACEF value upon admission can predict the cardiac mortality at 1 year following PCI with RA in heavily calcified coronary lesions patients.
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Affiliation(s)
- Hongwu Chen
- Department of Cardiology, The First Affiliated Hospital of USTC (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, No. 17 Lujiang Road, Luyang District, Hefei, 230001, Anhui Province, China
| | - Xiaofan Yu
- Department of Cardiology, The First Affiliated Hospital of USTC (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, No. 17 Lujiang Road, Luyang District, Hefei, 230001, Anhui Province, China
| | - Guangquan Qiu
- Department of Cardiology, The First Affiliated Hospital of USTC (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, No. 17 Lujiang Road, Luyang District, Hefei, 230001, Anhui Province, China
| | - Likun Ma
- Department of Cardiology, The First Affiliated Hospital of USTC (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, No. 17 Lujiang Road, Luyang District, Hefei, 230001, Anhui Province, China.
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Kebe B, Getachew M, Molla Y, Bahiru B, Dessie B. Management, survival, and predictors of mortality among hospitalized heart failure patients at Debre Markos comprehensive specialized hospital, Northwest Ethiopia: Prospective cohort study. SAGE Open Med 2021; 9:20503121211057336. [PMID: 34925834 PMCID: PMC8673877 DOI: 10.1177/20503121211057336] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 10/14/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction: Heart failure is a major public health problem worldwide. Since heart failure with reduced ejection fraction and preserved ejection fraction are different clinical entities, in-hospital mortality may occur at different rates. This study aimed to assess the management, survival, and predictors of mortality among hospitalized heart failure patients at Debre Markos comprehensive specialized medical ward. Methods: A prospective cohort study was conducted on 228 heart failure patients at Debre Markos Comprehensive Specialized Hospital medical wards. A structured data collection tool was used to collect data. Data were analyzed using SPSS version 21.0. The Kaplan–Meier survival curve was used to investigate if there was a difference in the in-hospital survival between heart failure with a reduced ejection fraction and heart failure with a preserved ejection fraction. Those variables having p-value < 0.05 were considered statistically significant. Results: From the 228 participants, 126 (55.3%) were females with a mean age of 53.32 ± 15.68 years. One hundred thirty-three (58.3%) patients were presented with preserved (⩾50%) level of ejection fraction. The all-cause in-hospital death rate was 12.7%, and the risk of in-hospital mortality was higher in heart failure patients with reduced ejection fraction (7.4% vs 5.3%; p = 0.005). Current occupation (p = 0.041), elevated serum creatinine (p = 0.010), reduced ejection fraction (p = 0.017), and asthma/chronic obstructive pulmonary disease comorbidity (p = 0.002) were the independent predictors of high hospital mortality. Conclusion: The rate of in-hospital mortality among heart failure patients was high. Healthcare providers should provide effective education activities and define disease management strategies for patients with reduced ejection fractions.
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Affiliation(s)
- Bekalu Kebe
- Clinical Pharmacy Unit, Department of Pharmacy, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Melese Getachew
- Pharmaceutics Unit, Department of Pharmacy, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Yalew Molla
- Pharmacology Unit, Department of Pharmacy, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Bereket Bahiru
- Social Pharmacy Unit, Department of Pharmacy, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Bekalu Dessie
- Clinical Pharmacy Unit, Department of Pharmacy, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
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Ösken A, Hacı R, Şekerci SS, Asarcıklı LD, Yüksel G, Ceylan B, Dayı ŞÜ, Çam N. Predictive value of the age, creatinine and ejection fraction score in patients undergoing primary percutaneous coronary intervention with bail-out tirofiban therapy. ADVANCES IN INTERVENTIONAL CARDIOLOGY 2021; 17:170-178. [PMID: 34400919 PMCID: PMC8356837 DOI: 10.5114/aic.2021.107495] [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: 03/11/2021] [Accepted: 04/20/2021] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION In patients who have undergone interventional cardiac procedures, the risk of bleeding is higher than in patients who received conservative treatment due to multiple medications and comorbidities. AIM This study aimed to evaluate the usefulness of the age, creatinine and ejection fraction (ACEF) score for predicting bleeding events and to compare short- and long-term clinical outcomes according to the ACEF score in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI) with bail-out tirofiban therapy (BOTT). MATERIAL AND METHODS A total of 2,543 patients were included and divided into three groups according to the following ACEF score tertiles: T1 (ACEFlow ≤ 1.033), T2 (1.033 < ACEFmid ≤ 1.371), and T3 (ACEFhigh > 1.371). The main outcomes measured were the incidence rates of relevant bleeding events and mortality within 30 days and 3 years after the procedure. RESULTS A total of 73 (2.9%) patients had Bleeding Academic Research Consortium bleeding events of grades 3, 4 or 5 and 104 (4%) patients died in a 30-day period. The ACEF score was effective at predicting 30-day bleeding (area under the receiver operating characteristic curve (AUC): 0.658, 95% confidence interval (CI): 0.579-0.737; p < 0.001), 30-day mortality (AUC = 0.701, 95% CI: 0.649-0.753; p < 0.001) and 3-year mortality (AUC = 0.778, 95% CI: 0.748-0.807; p < 0.001) events. Considering the ACEF score tertiles, T3 patients presented greater 30-day bleeding (1.6%, 2.8% and 4.1%; odds ratio (OR) = 2.56, 95% CI: 1.37-4.80), 30-day mortality (1.7%, 3.5% and 7.1%; OR = 4.53, 95% CI: 2.51-8.18) and 3-year mortality (6.4%, 11% and 19.8%; hazard ratio = 3.56, 95% CI: 2.58-4.91) risks. CONCLUSIONS The ACEF score is a user-friendly tool with excellent predictive value for bleeding events and mortality in patients undergoing pPCI with BOTT.
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Affiliation(s)
- Altuğ Ösken
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey
| | - Recep Hacı
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey
- Department of Cardiology, Yalova State Hospital, Yalova, Turkey
| | - Sena Sert Şekerci
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey
| | - Lale Dinç Asarcıklı
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey
| | - Gizem Yüksel
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey
| | - Büşra Ceylan
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey
| | - Şennur Ünal Dayı
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey
| | - Neşe Çam
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey
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