The Risk of Cardiovascular Events After an Acute Coronary Event Remains High, Especially During the First Year, Despite Revascularization

Abu‐Assi, Emad; López‐López, Andrea; González-Salvado, Violeta; Diéguez, Alfredo Redondo; Peña‐Gil, Carlos; Bouzas-Cruz, Noelia; Raposeiras‐Roubín, Sergio; Abumuaileq, Rami Riziq-Yousef; Garcı́a-Acuña, José Marı́a; González-Juanàtey, José Ramón

doi:10.1016/j.rec.2015.06.015

Cited by 38 publications

(35 citation statements)

References 27 publications

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“…The risk of recurrence of cardiovascular events remains high after acute coronary syndrome. 23,24) Type 2 diabetes as another predictor of recurrence identified in our study had already been previously described, [23][24][25][26] but it exerted more influence on the patients before menopause. Because of the much greater complexity of the vascular lesions, the recurrence rate of women after menopause is related to the Gensini score.…”

Section: Discussionsupporting

confidence: 69%

Coronary Artery Disease in Premenopausal and Postmenopausal Women

Jiang

Dong-shen³

2017

Int. Heart J.

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SummaryThe purpose was to determine the differences between premenopausal and postmenopausal coronary artery disease (CAD) risk factors, clinical manifestation, cardiovascular features, rates of recurrence, and influencing factors.Premenopausal (n = 57) and postmenopausal (n = 178) CAD women hospitalized during the same period were enrolled. All patients were followed-up, and the combined recurrence of major adverse cardiovascular events was recorded as the clinical outcome. Differences were compared between the 2 groups.Fewer premenopausal women suffered from hypertension (43.86% versus 75.28%, P < 0.001), type 2 diabetes (12.28% versus 35.96%, P = 0.001), and hyperlipidemia (5.26% versus 34.83%, P < 0.001), but more had a positive family history of premature CAD (40.35% versus 25.28%, P = 0.03). Acute coronary syndrome (ACS) was more frequently seen in premenopausal women (82.46% versus 48.88%, P < 0.001), and their left anterior descending branch was the vessel most often involved (65.33%). The cumulative recurrence rate was 1.76 times higher in postmenopausal patients than premenopausal patients. Clinical diagnosis (HR = 2.54, 95%CI: 1.21-4.85, P = 0.02) and type 2 diabetes (HR = 4.10, 95%CI: 2.37-8.83, P = 0.004) were two factors that influenced recurrence in premenopausal subjects, while the clinical diagnosis (HR = 1.93, 95%CI: 1.59-3.46, P = 0.03) and Gensini score (HR = 1.20, 95%CI: 1.11-1.45, P = 0.02) were influencing factors in the postmenopausal patients.Symptoms among younger women were atypical, but the onset of disease was faster and more urgent, and angiography in premenopausal women might underestimate the severity of disease. The risk factors, rate of recurrence, and influencing factors were different between premenopausal and postmenopausal patients. (Int Heart J 2017; 58: 174-179)

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Section: Discussionsupporting

confidence: 69%

Coronary Artery Disease in Premenopausal and Postmenopausal Women

Jiang

Dong-shen³

2017

Int. Heart J.

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“…A significant proportion of patients experience adverse coronary events beyond the first year following ACS . While our analysis was exploratory in nature, as dictated by the constraints of an observational study, we confirmed the persistence of ischemic risk post‐ACS in EPICOR Spain patients: all‐cause mortality continued to accumulate after the first year following discharge (1 year, 3.7%; 2 years, 5.8%).…”

Section: Discussionsupporting

confidence: 60%

“…Several studies have shown that the risk of a recurrent cardiovascular event persists beyond the first year following discharge from hospital, even in patients who have remained event‐free during this period . A number of trials and meta‐analyses also suggest that prolonged DAPT reduces the incidence of ischemic events compared with standard duration, although at the expense of increased potential for bleeding .…”

Section: Introductionmentioning

confidence: 99%

Extended dual antiplatelet therapy after acute coronary syndrome in Spain: Results from the EPICOR study

Bardajı́

Leal

Arrarte

et al. 2017

Cardiovascular Therapeutics

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“…A retrospective analysis of 292 patients found that 2year survival rate of elderly patients with CCI score > 9 was 38%, and that of patients with CCI < 7 reached 69% [30]. Elderly PD patients often suffer with ISD, and the risk of recurrence with cardiovascular and cerebrovascular events increases [31],so elderly PD patients are at high risk of death.…”

Section: Discussionmentioning

confidence: 99%

Characteristics and prognostic outcome factors in elderly peritoneal dialysis patients:a prospective observational study

Sun³

2020

Preprint

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Background: This study aimed to analyze the characteristics, outcomes and prognosis factors of survival in elderly peritoneal dialysis patients, so as to better understand the status of elderly peritoneal dialysis patients and improve their quality of life.Methods: This study was a prospective, observational study that included peritoneal dialysis (PD)patients.Categorizing by age, elderly group aged ≥ 65, younger group aged < 65. Clinical characteristics, survival and transferring to hemodialysis were compared between two groups.Meanwhile, risk factors for death in elderly PD patients were explored.Results: A total of 202 PD patients were enrolled, including 61 in elderly group and 141 in younger group. Among elderly individuals,serum albumin and normalized protein catabolic rate(nPCR) decreased, the incidence of previous cardiovascular, cerebrovascular diseases and Charlson Comorbidity Index(CCI) were higher.The major primary disease in elderly patients was diabetic nephropathy, significant differences were found between elderly and younger group(P < 0.01). The mortality in elderly group was substantially higher, 27 patients (44.3%) died in elderly group and 21 patients(14.3%) died in younger group .The 1-year,2-year,3-year,4-year survival rate were 81.97%, 70.49%, 60.66%, 55.74% respectively. Cardiovascular disease was the main cause of death in elderly PD patients. Higher BMI, CCI, and previous ischemic heart disease were risk factors for long-term survival of elderly PD patients. Compared with the younger group, elderly patients were less likely to transfer to hemodialysis: 2 cases (3.3%) in elderly group and 23 cases (16.3%) in younger group. Peritonitis was the primary reason for converting to hemodialysis(HD) in both two groups.Conclusions: Poor nutrition, more complications and diabetic nephropathy were characteristics of elderly PD patients. High BMI, CCI and previous ischemic heart disease were independent predictors of death in elderly PD patients. Cardiovascular disease was the main cause of death in elderly PD patients，while the chief reason of transferring to hemodialysis was peritonitis.

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The Risk of Cardiovascular Events After an Acute Coronary Event Remains High, Especially During the First Year, Despite Revascularization

Cited by 38 publications

References 27 publications

Coronary Artery Disease in Premenopausal and Postmenopausal Women

Coronary Artery Disease in Premenopausal and Postmenopausal Women

Extended dual antiplatelet therapy after acute coronary syndrome in Spain: Results from the EPICOR study

Characteristics and prognostic outcome factors in elderly peritoneal dialysis patients:a prospective observational study

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