One-Year Outcomes After Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction With Varying Quantities of Coronary Artery Calcium (from a 13-Year Registry)

Vaduganathan, Muthiah; Kornowski, Ran; Qamar, Arman; Greenberg, Gabriel; Bental, Tamir; Rechavia, Eldad; Lev, Eli I.; Vaknin‐Assa, Hana; Assali, Abid

doi:10.1016/j.amjcard.2016.07.022

Cited by 2 publications

(4 citation statements)

References 28 publications

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“…Recent studies from the United States, Israel, Spain, Austria, Poland, China, and Brazil reported all-cause one-year AMI mortality rates ranging from 3% to 19%. [30][31][32][33][34][35][36][37] Thus the mortality rate observed in our cohort is far in excess of what is experienced in highincome settings outside of SSA. Caution is warranted, however, when making comparisons between mortality rates in Tanzania and high-income countries, as general life expectancy in Tanzania (65 years in 2019) 38 is lower than these comparator countries, which may explain some of the differences in observed mortality.…”

Section: Discussionmentioning

confidence: 99%

One-Year Outcomes and Factors Associated With Mortality Following Acute Myocardial Infarction in Northern Tanzania

Hertz

Sakita

Kweka

et al. 2022

Circ: Cardiovascular Quality and Outcomes

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Background: Little is known about long-term outcomes and uptake of secondary preventative therapies following acute myocardial infarction (AMI) in sub-Saharan Africa. Methods: Consecutive patients presenting with AMI (as defined by the Fourth Universal Definition of AMI Criteria) to a northern Tanzanian referral hospital were enrolled in this prospective observational study. Follow-up surveys assessing mortality, medication use, and rehospitalization were administered at 3, 6, 9, and 12 months following initial presentation, by telephone or in person. Multivariate logistic regression was performed to identify baseline clinical and sociodemographic factors associated with one-year mortality. Results: Of 152 enrolled patients with AMI, 5 were lost to one-year follow-up (96.7% retention rate). Mortality rates were 34.9% (53 of 152 participants) during the initial hospitalization, 48.7% (73 of 150 patients) at 3 months, 52.7% (78 of 148 patients) at 6 months, 55.4% (82 of 148 patients) at 9 months, and 59.9% (88 of 147 patients) at one year. Of 59 patients surviving to one-year follow-up, 43 (72.9%) reported persistent anginal symptoms, 5 (8.5%) were taking an antiplatelet, 8 (13.6%) were taking an antihypertensive, 30 (50.8%) had been rehospitalized, and 7 (11.9%) had ever undergone cardiac catheterization. On multivariate analysis, one-year mortality was associated with lack of secondary education (odds ratio, 0.26 [95% CI, 0.11–0.58]; P =0.001), lower body mass index (odds ratio, 0.90 [95% CI, 0.82–0.98]; P =0.015), and higher initial troponin (odds ratio, 1.30 [95% CI, 1.05–1.80]; P =0.052). Conclusions: In northern Tanzania, AMI is associated with high all-cause one-year mortality and use of evidence-based secondary preventative therapies among AMI survivors is low. Interventions are needed to improve AMI care and outcomes.

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Section: Discussionmentioning

confidence: 99%

One-Year Outcomes and Factors Associated With Mortality Following Acute Myocardial Infarction in Northern Tanzania

Hertz

Sakita

Kweka

et al. 2022

Circ: Cardiovascular Quality and Outcomes

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“…In 687 men who did not self-report IHD, severe PAC (6+) was associated with higher risk of ACS (HR, 6 0.89-10.70], P=0.075), but only 30 men with ACS were in this analysis. In 722 men who did not report pharmacologically treated diabetes, severe PAC (6+) was associated with higher risk of ACS (HR, 6.32 [95% CI, 2.12-18.77], P<0.001) and higher risk of MACE (HR, 3.18 [95% CI, 1.45-6.98], P<0.005).…”

Section: Sensitivity Analysis-clinical Status At Baselinementioning

confidence: 90%

“…AAC and PAC score correlated (r=0.13, P<0.001). AAC score was higher in men with PAC score 6+ (5 [1][2][3][4][5][6][7][8][9][10][11] versus 1 [0-3], P<0.001), also after adjustment for age (P<0.001). The ACS incidence was higher in men with AAC score 5+ (…”

Section: Abdominal Aortic Calcificationmentioning

confidence: 99%

“…1–4 Calcification is associated with higher risk of acute coronary syndrome (ACS), major adverse cardiovascular event (MACE), poor prognosis after coronary intervention, and higher all-cause and cardiovascular mortality. 1–6 By contrast, few studies concerned smaller peripheral arteries, such as brachial, radial, hand, breast, uterine/spermatic, or crural arteries. 7–14 Most of these studies were performed in patients with ischemic heart disease (IHD), renal failure, diabetes or peripheral artery disease, who had severe arterial calcification.…”

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confidence: 99%

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High Cardiovascular Risk in Older Men With Severe Peripheral Artery Calcification on High-Resolution Peripheral QCT Scans

Szulc

Planckaert

Foesser

et al. 2021

ATVB

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Objective: Arterial calcification is associated with high cardiovascular risk. Our aim was to assess the utility of peripheral arterial calcification (PAC) in distal forearm and distal leg for the prediction of acute coronary syndrome (ACS) and major adverse cardiovascular event in older men. Approach and Results: In 815 home-dwelling older men, PAC was assessed on the scans of distal forearm and leg obtained by high-resolution peripheral quantitative computed tomography. PAC score (0–12) was calculated on the basis of the number and severity in small peripheral arteries. The information on ACS and major adverse cardiovascular event was collected prospectively for 8 years. PAC severity increased with age and body mass index ( P <0.001). Median PAC score was higher in men with ischemic heart disease or pharmacologically treated diabetes ( P <0.001). After adjustment for confounders, the risk of ACS was higher in men with severe PAC (6+) versus men with lower PAC (0–5; HR, 3.86 [95% CI, 1.65–9.02], P <0.005). After adjustment for confounders, the risk of major adverse cardiovascular event was higher in men with severe PAC (6+) versus men with lower PAC (HR, 2.58 [95% CI, 1.41–4.72], P <0.005). In men who did not have cardiovascular risk factors, severe PAC was associated with higher risk of ACS, for example, in men who did not self-report ischemic heart disease (HR, 6.62 [95% CI, 2.16–20.23], P <0.001). Conclusions: Severe PAC is associated with higher risk of ACS and major adverse cardiovascular event in older home-dwelling men, also in men without known ischemic heart disease. Incidentally found severe PAC can be a serious warning indicating high cardiovascular risk.

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One-Year Outcomes After Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction With Varying Quantities of Coronary Artery Calcium (from a 13-Year Registry)

Cited by 2 publications

References 28 publications

One-Year Outcomes and Factors Associated With Mortality Following Acute Myocardial Infarction in Northern Tanzania

One-Year Outcomes and Factors Associated With Mortality Following Acute Myocardial Infarction in Northern Tanzania

High Cardiovascular Risk in Older Men With Severe Peripheral Artery Calcification on High-Resolution Peripheral QCT Scans

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