Global epidemiology of acute coronary syndromes

Kazakiewicz, Denis; Townsend, Nick; Huculeci, Radu; Aboyans, Victor; Vardas, Panos

doi:10.1038/s41569-023-00884-0

Cited by 28 publications

(10 citation statements)

References 40 publications

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“…Cardiovascular disease (CVD) remains the leading cause of death worldwide, with an estimated 17.9 million fatalities annually. Among these, acute coronary syndrome (ACS) is a significant contributor to CVD-related mortality [ 1 ]. ACS encompasses a cluster of conditions characterized by impaired myocardial function or necrosis due to diminished blood flow in the coronary arteries [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Association between the triglyceride-glucose index and in-hospital major adverse cardiovascular events in patients with acute coronary syndrome: results from the Improving Care for Cardiovascular Disease in China (CCC)-Acute Coronary Syndrome project

Wang,

Yang,

Wang

et al. 2024

Cardiovasc Diabetol

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Objective Although the TyG index is a reliable predictor of insulin resistance (IR) and cardiovascular disease, its effectiveness in predicting major adverse cardiac events in hospitalized acute coronary syndrome (ACS) patients has not been validated in large-scale studies. In this study, we aimed to explore the association between the TyG index and the occurrence of MACEs during hospitalization. Methods We recruited ACS patients from the CCC-ACS (Improving Cardiovascular Care in China-ACS) database and calculated the TyG index using the formula ln(fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). These patients were classified into four groups based on quartiles of the TyG index. The primary endpoint was the occurrence of MACEs during hospitalization, encompassing all-cause mortality, cardiac arrest, myocardial infarction (MI), and stroke. We performed Cox proportional hazards regression analysis to clarify the correlation between the TyG index and the risk of in-hospital MACEs among patients diagnosed with ACS. Additionally, we explored this relationship across various subgroups. Results A total of 101,113 patients were ultimately included, and 2759 in-hospital MACEs were recorded, with 1554 (49.1%) cases of all-cause mortality, 601 (21.8%) cases of cardiac arrest, 251 (9.1%) cases of MI, and 353 (12.8%) cases of stroke. After adjusting for confounders, patients in TyG index quartile groups 3 and 4 showed increased risks of in-hospital MACEs compared to those in quartile group 1 [HR = 1.253, 95% CI 1.121–1.400 and HR = 1.604, 95% CI 1.437–1.791, respectively; p value for trend < 0.001], especially in patients with STEMI or renal insufficiency. Moreover, we found interactions between the TyG index and age, sex, diabetes status, renal insufficiency status, and previous PCI (all p values for interactions < 0.05). Conclusions In patients with ACS, the TyG index was an independent predictor of in-hospital MACEs. Special vigilance should be exercised in females, elderly individuals, and patients with renal insufficiency.

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Section: Introductionmentioning

confidence: 99%

Association between the triglyceride-glucose index and in-hospital major adverse cardiovascular events in patients with acute coronary syndrome: results from the Improving Care for Cardiovascular Disease in China (CCC)-Acute Coronary Syndrome project

Wang,

Yang,

Wang

et al. 2024

Cardiovasc Diabetol

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“…According to the American Heart Association, one heart attack occurs approximately every 41 s [ 3 ]. Age-standardized mortality rates (ASMRs) for ACS were highest in lower-income global regions in 2020 for both sexes [ 4 ]. Some recent guidelines recommend the use of statins as the major therapy for atherosclerotic cardiovascular disease (ASCVD), including ACS [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Cost–utility analysis of using high-intensity statin among post-hospitalized acute coronary syndrome patients

Dewi,

Thavorncharoensap,

Rahajeng

2024

Egypt Heart J

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Background Post-hospitalized acute coronary syndrome (ACS) patients in Indonesia National Insurance does not pay for the use of high-intensity statin (HIS) for secondary prevention after ACS hospitalization. Moreover, a cost–utility analysis needs to be conducted to evaluate the cost-effectiveness of prescribing HIS and low-to-moderate-intensity statin (LMIS) per quality-adjusted life year (QALY). This study aimed to estimate the cost–utility of long-term HIS treatment in post-hospitalized ACS patients in Indonesia compared to current practice. Results This study compared the economic outcomes of long-term HIS and LMIS in Indonesian post-hospitalized ACS patients. A lifetime Markov model predicted ACS-related events, costs, and QALY from a payer perspective. A systematic review estimated treatment-specific event probabilities, post-event survival, health-related quality of life, and Indonesia medical-care expenses from published sources. This study conducted probabilistic sensitivity analysis (PSA) using 1000 independent Monte Carlo simulations and a series of one-way deterministic sensitivity analyses utilizing a tornado diagram. The economic evaluation model proved that intensive HIS treatment can increase per-patient QALYs and care expenditures compared to LMIS. The use of HIS among post-hospitalized ACS patients had ICER 31.843.492 IDR per QALY gained, below the Indonesia willingness-to-pay (WTP) for terminal disease and life-saving treatment. Conclusion From the Indonesia payer perspective, using HIS for post-hospitalized ACS patients in Indonesia is cost-effective at 31.843.492 IDR per QALY gained.

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“…Cardiovascular disease, is one among the major causes of mortality in general population 1 .Acute coronary syndromes (ACS) play a signi cant role in cardiovascular disease related mortality 1 .The restoration of blood ow through the culprit artery by PCI results in the recovery of left ventricular (LV) functions and it can be evaluated through various systolic function parameters. Regardless of the treatment method, occurrence of MACE ranges from 4.2-51%, follow-up studies have been conducted for up to 10 years from the time of diagnosis of STEMI 2 .Major adverse cardiac events include stroke due to thrombotic embolism, death due to cardiac rupture or life-threatening arrhythmia's such as VT or VF, heart failure can end up with pulmonary edema, non-fatal re-infarction and other complications like recurrent chest pain, admission for cardiac related complaints, repeat re perfusion therapy or coronary artery bypass grafting (CABG) 3 .…”

Section: Introductionmentioning

confidence: 99%

Longitudinal Assessment of Left Ventricle Systolic Function in Acute Myocardial Infarction Patients Post Percutaneous Coronary Intervention

Bansal

Lalani

et al. 2023

Preprint

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Purpose: The present study aimed to longitudinally evaluate LV systolic function among patients who underwent primary PCI for acute MI on the basis of culprit vessel. Methods: A Cohort study was conducted involving 258 patients who underwent primary angioplasty for Acute MI. Each participant underwent an initial echocardiography assessment using a range of methods, including M-mode and two-dimensional measurements, as well as strain and strain rate parameters. Subjects were followed up for a period of one month to assess the LV systolic function. Results: A significant improvement in LV global strain noted after one month of revascularization (p value=0.013). A significant decrease in Left ventricular global longitudinal strain (LV GLS) value is noted in patients who had major adverse cardiac events (MACE) when compare to event free group. Wall motion score index value and LV end systolic volume were significantly higher in MACE category than event free category. Conclusion: A study demonstrated an enhancement in left ventricular (LV) systolic function,when measured using Speckle tracking echocardiography than LVEF irrespective of culprit vessel. MACE occurred in 4.3% of Acute MI patients even after successful PCI. The Baseline LV EF and Wall motion score index was proved to be independent predictor of Major adverse cardiac events at one-month follow-up than LV strain.

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Global epidemiology of acute coronary syndromes

Cited by 28 publications

References 40 publications

Association between the triglyceride-glucose index and in-hospital major adverse cardiovascular events in patients with acute coronary syndrome: results from the Improving Care for Cardiovascular Disease in China (CCC)-Acute Coronary Syndrome project

Association between the triglyceride-glucose index and in-hospital major adverse cardiovascular events in patients with acute coronary syndrome: results from the Improving Care for Cardiovascular Disease in China (CCC)-Acute Coronary Syndrome project

Cost–utility analysis of using high-intensity statin among post-hospitalized acute coronary syndrome patients

Longitudinal Assessment of Left Ventricle Systolic Function in Acute Myocardial Infarction Patients Post Percutaneous Coronary Intervention

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