Further Validation of a Novel Acute Myocardial Infarction Risk Stratification (nARS) System for Patients with Acute Myocardial Infarction

Sawano, Shinnosuke; Sakakura, Kenichi; Yamamoto, Kei; Taniguchi, Yousuke; Tsukui, Takunori; Seguchi, Masaru; Wada, Hiroshi; Momomura, Shin‐ichi; Fujita, Hideo

doi:10.1536/ihj.19-678

Cited by 10 publications

(10 citation statements)

References 28 publications

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“…18) Hypertension was defined as systolic blood pressure (SBP) > 140 mmHg or medical treatment for hypertension. 19) Diabetes mellitus was defined as hemoglobin A1c "6.5% (national glycolhemoglobin standardization program (NGSP) value) or treatment for diabetes mellitus. 20,21) Dyslipidemia was defined as total cholesterol " 220 mg/dL, low-density lipoprotein cholesterol " 140 mg/dL, or treatment for dyslipidemia.…”

Section: Methodsmentioning

confidence: 99%

Factors Associated with In-Hospital Death in Patients with Killip Class 3 Acute Myocardial Infarction

et al. 2021

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The clinical outcomes in acute myocardial infarction (AMI) patients with Killip class 3 are often inconsistent with those in the literature, and the factors associated with poor outcomes have not been sufficiently investigated. The purpose of this study was to identify factors associated with in-hospital death in AMI patients with Killip class 3. We included 205 AMI patients with Killip class 3, and divided them into a survived group (n = 189) and in-hospital death group (n = 16). The primary objective was to identify factors associated with inhospital death using multivariate analysis. Age was significantly younger in the survived group than in the inhospital death group (73.1 ± 11.2 versus 83.2 ± 6.2 years, P < 0.001). Systolic blood pressure (SBP) was significantly higher in the survived group than in the in-hospital death group (150.0 ± 31.2 versus 124.8 ± 25.3 mmHg, P = 0.002). The prevalence of TIMI thrombus grade "2 was significantly greater in the in-hospital death group than in the survived group (56.3 versus 22.2%, P = 0.005). In multivariate logistic regression analysis, in-hospital death was significantly associated with age [odds ratio (OR) 1.168, 95% confidence interval (CI) 1.061-1.287, P = 0.002] and TIMI thrombus grade "2 (versus !1: OR 5.743, 95% CI 1.717-19.214, P = 0.005), and inversely associated with SBP on admission (per 10 mmHg increase: OR 0.764, 95% CI 0.613-0.953, P = 0.017). In conclusion, in-hospital death was associated with age and coronary thrombus burden, and was inversely associated with SBP on admission in patients with Killip class 3. It may be important to recognize these high risk features to improve the clinical outcomes of patients with Killip class 3.

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Section: Methodsmentioning

confidence: 99%

Factors Associated with In-Hospital Death in Patients with Killip Class 3 Acute Myocardial Infarction

et al. 2021

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“…7,9) Dyslipidemia was defined as total cholesterol levels > 220 mg/dL or low-density lipoprotein cholesterol levels > 140 mg/dL or medical treatment for dyslipidemia or a history of dyslipidemia. 10) Diabetes mellitus was defined as a hemoglobin A1c level (as NGSP value) > 6.5% or a medical treatment for diabetes mellitus or a history of diabetes mellitus. 11) Significant coronary artery stenosis was defined as at least a 75% reduction in the internal diameter.…”

Section: Methodsmentioning

confidence: 99%

Comparison of Clinical Outcomes of Acute Myocardial Infarction Between Prasugrel and Clopidogrel

et al. 2021

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The rapid introduction of dual antiplatelet therapy (DAPT) is important for patients with acute myocardial infarction (AMI). The risks and benefits of reduced-dose prasugrel (20 mg loading and 3.75 mg maintenance) over clopidogrel have not been fully discussed. The purpose of this study was to compare the 90-days clinical outcomes of AMI between prasugrel-based DAPT and clopidogrel-based DAPT. We included 534 AMI patients and divided them into the clopidogrel group (n = 330) and the prasugrel group (n = 204). The primary endpoint was the total ischemic events and total bleeding events. In all, 52 ischemic events and 35 bleeding events were observed during the study period. The total ischemic events were similar between the clopidogrel and the prasugrel groups (P = 0.385). The total bleeding events were similar between the clopidogrel and the prasugrel groups (P = 0.125). The multivariate Cox hazard analysis showed that prasugrel was not associated with the total ischemic events (hazard ratio (HR) 0.955, 95% confidence interval (CI) 0.499-1.829, P = 0.890) and was not associated with the total bleeding events after controlling confounding factors (HR 0.972, 95% CI 0.528-1.790, P = 0.927). In conclusion, as compared to clopidogrel, the reduced dose of prasugrel was not associated with the excess risk of bleeding or the excess risk of ischemic events. Our real-world data support the current regimen of prasugrel for AMI patients who underwent primary percutaneous coronary intervention.

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“…Hypertension was defined as medical treatment for hypertension or a history of hypertension before admission [9,10]. Dyslipidaemia was defined as a total cholesterol level ≥ 220 mg/dl, low-density lipoprotein cholesterol level ≥ 140 mg/dl, medical treatment for dyslipidaemia, or a history of dyslipidaemia [11][12][13]. Diabetes mellitus was defined as a haemoglobin A 1c level ≥ 6.5% (as NGSP value), medical treatment for diabetes mellitus, or a history of diabetes mellitus [11].…”

Section: Definitionmentioning

confidence: 99%

Factors associated with aorto-ostial stent coverage during intravascular ultrasound-guided percutaneous coronary intervention to severely narrowed non-ostial right coronary artery lesions

Narita¹,

Sakakura²,

Taniguchi³

et al. 2021

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Introduction: In percutaneous coronary intervention (PCI) to atherosclerotic lesions in the right coronary artery (RCA), coronary artery dissection in the ostium of the RCA is a rare but fatal complication. Stent implantation to the ostium of RCA may be selected for the prevention of aorto-ostial dissection.Aim: To find factors associated with aorto-ostial stent coverage to mild to moderate ostial stenosis during the treatment of severely narrowed non-ostial RCA lesions.Material and methods: The primary interest was to find factors associated with ostial stent coverage using multivariate regression analysis. We included 236 patients who underwent intravascular ultrasound (IVUS)-guided PCI to severely narrowed RCA lesions with mild to moderate ostial stenosis, and divided those into the ostial-coverage group (n = 52) and the non-coverage group (n = 184).Results: The prevalence of continuous ostial plaque detected by intravascular ultrasound (IVUS) was significantly greater in the ostial-coverage group (84.6%) than in the non-coverage group (52.9%) (p < 0.001). Multivariate logistic regression analysis revealed that continuous ostial plaque detected by IVUS (OR = 5.398, 95% CI: 2.322-12.553, p < 0.001) was significantly associated with ostial stent coverage after controlling confounding factors. Ischaemia-driven target vessel revascularization was less frequently observed in the ostial-coverage group than in the non-coverage group, without reaching statistical significance (p = 0.069).Conclusions: Continuous ostial plaque detected by IVUS was significantly associated with ostial stent coverage to the mild to moderate stenosis when PCI to non-ostial, severely narrowed RCA lesions was performed. The use of IVUS may enhance the safety but may increase the total stent length in PCI to RCA.

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Further Validation of a Novel Acute Myocardial Infarction Risk Stratification (nARS) System for Patients with Acute Myocardial Infarction

Cited by 10 publications

References 28 publications

Factors Associated with In-Hospital Death in Patients with Killip Class 3 Acute Myocardial Infarction

Factors Associated with In-Hospital Death in Patients with Killip Class 3 Acute Myocardial Infarction

Comparison of Clinical Outcomes of Acute Myocardial Infarction Between Prasugrel and Clopidogrel

Factors associated with aorto-ostial stent coverage during intravascular ultrasound-guided percutaneous coronary intervention to severely narrowed non-ostial right coronary artery lesions

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