Event Rates and Risk Factors for Recurrent Cardiovascular Events and Mortality in a Contemporary Post Acute Coronary Syndrome Population Representing 239 234 Patients During 2005 to 2018 in the United States

Abstract

Background Patients with acute coronary syndrome (ACS) are recognized by guidelines as remaining at high risk for adverse outcomes. Evidence from contemporary, representative ACS populations in a clinical practice setting is necessary to identify subgroups and strategies for improving patient outcomes. We aimed to describe event rates and risk factors in an ACS population over prolonged follow‐up for cardiovascular end points. Methods and Results We identified 239 234 patients in the Optum Research Database (57.2% men; mean [standard deviation] age, 69.2 [12.2] years) with evidence of an ACS hospitalization (index ACS) during January 1, 2005 through December 30, 2018. Subgroups were based on index ACS event (myocardial infarction/unstable angina and revascularization status) and the Thrombolysis In Myocardial Infarction Risk Score for Secondary Prevention. The 5‐year event rate for the primary end point representing nonfatal myocardial infarction, nonfatal ischemic stroke, and cardiovascular death was 33.4% (95% CI, 33.1%–33.7%; P <0.001). The risk of experiencing the primary end point was ≈6‐fold higher immediately after discharge (≈40.9% annualized risk) as compared with the period 1+ years after hospitalization (≈6.4% annualized risk). Among subgroups, the 5‐year primary end point event rate was highest for myocardial infarction without revascularization and a Thrombolysis In Myocardial Infarction Risk Score for Secondary Prevention ≥4, at 47.9% (95% CI, 47.3%–48.4%; P <0.001) and 56.7% (95% CI, 55.9%–57.4%; P <0.001), respectively. Conclusions Patients with ACS remain at very high risk of experiencing recurrent cardiovascular events, particularly early after discharge, with identifiable subgroups at multifold higher risk of specific clinical end points.

A Phase 3 Randomized Controlled Trial to Evaluate Efficacy and Safety of New-Formulation Zenon (Rosuvastatin/Ezetimibe Fixed-Dose Combination) in Primary Hypercholesterolemia Inadequately Controlled by Statins

“…21,22 However, in a recent real-world evidence study of acute coronary syndrome, with 97% of participants classified as VHR, the reported rate of heart failure was 35.7%, comparable to the rate observed in the VHR stratum in the present study. 23 The EAS Task Force recommends statin-ezetimibe combination therapy as a first-choice treatment for patients diagnosed with dyslipidemia at very high risk of CVD. [9][10][11] The combination of rosuvastatin and ezetimibe in one formulation utilizes the different mechanisms of action of the two products and offers a simplified treatment regimen.…”

“…21,22 However, in a recent real-world evidence study of acute coronary syndrome, with 97% of participants classified as VHR, the reported rate of heart failure was 35.7%, comparable to the rate observed in the VHR stratum in the present study. 23…”

Optical and X-ray attenuation properties of hafnium oxide nanoparticles surface functionalized with fucoidan: toward the early diagnosis of atherothrombotic diseases

“…Atherothrombotic events represent the main cause of mortality and morbidity in the world, 1,2 involving both the arterial and the venous part of the circulation: myocardial infarction, ischemic stroke, aneurysms, peripheral arterial disease, atrial thrombus and embolisms, phlebothrombosis and pulmonary embolisms. Many thrombotic events could be diagnosed before dramatic complications occur.…”

Predictive Value of Cardiovascular Health Score for Health Outcomes in Patients with PCI: Comparison between Life’s Simple 7 and Life’s Essential 8

“…Acute coronary syndrome (ACS) results from a plaque-related acute thrombus, causing major adverse cardiac events (MACEs) [ 1 ]. Percutaneous coronary intervention (PCI) remains the primary interventional treatment for ACS [ 2 , 3 ].…”