Underestimated and under-recognized: the late consequences of acute coronary syndrome (GRACE UK-Belgian Study)

Fox, Keith A.A.; Carruthers, Kathryn; Dunbar, Donald R.; Graham, Catriona; Manning, Jonathan; Raedt, Herbert De; Buysschaert, Ian; Lambrechts, Diether; Werf, Frans Van de

doi:10.1093/eurheartj/ehq326

Cited by 387 publications

(284 citation statements)

References 22 publications

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“…These results are comparable to the Filipiak et al (2014) study, performed with a group of 906 patients suffering from ACS and with an average age of 63 years, where the death rate was 29%, as well as with another study, conducted by Ezekowitz et al (2009), with a population-based cohort of 7,733 patients above 65 years, where the death rate was 28%. The multicentre research GRACE performed on 3,721 patients in Great Britain (2065 patients) and Belgium (1656 patients) showed that 20.0% of deaths had followed myocardial infarction, which was comparable with the result obtained in our research during a 5-year follow-up, including cases with STEMI -19.0%, NSTEMI -22.0%, and unstable angina -18.0% (Fox et al, 2010).…”

Section: Discussionsupporting

confidence: 88%

Limitations of Cox Proportional Hazards Analysis in Mortality Prediction of Patients with Acute Coronary Syndrome

Babińska

Chudek

Chełmecka

et al. 2015

Studies in Logic, Grammar and Rhetoric

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Abstract. The aim of this study was to evaluate the possibility of incorrect assessment of mortality risk factors in a group of patients affected by acute coronary syndrome, due to the lack of hazard proportionality in the Cox regression model. One hundred and fifty consecutive patients with acute coronary syndrome (ACS) and no age limit were enrolled. Univariable and multivariable Cox proportional hazard analyses were performed. The proportional hazard assumptions were verified using Schoenfeld residuals, χ2 test and rank correlation coefficient t between residuals and time. In the total group of 150 patients, 33 (22.0%) deaths from any cause were registered in the follow-up time period of 64 months. The non-survivors were significantly older and had increased prevalence of diabetes and erythrocyturia, longer history of coronary artery disease, higher concentrations of serum creatinine, cystatin C, uric acid, glucose, C-reactive protein (CRP), homocysteine and B-type natriuretic peptide (NT-proBNP), and lower concentrations of serum sodium. No significant differences in echocardiography parameters were observed between groups. The following factors were risk of death factors and fulfilled the proportional hazard assumption in the univariable model: smoking, occurrence of diabetes and anaemia, duration of coronary artery disease, and abnormal serum concentrations of uric acid, sodium, homocysteine, cystatin C and NT-proBNP, while in the multivariable model, the risk of death factors were: smoking and elevated concentrations of homocysteine and NT-proBNP. The study has demonstrated that violation of the proportional hazard assumption in the Cox regression model may lead to creating a false model that does not include only time-independent predictive factors.

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Section: Discussionsupporting

confidence: 88%

Limitations of Cox Proportional Hazards Analysis in Mortality Prediction of Patients with Acute Coronary Syndrome

Babińska

Chudek

Chełmecka

et al. 2015

Studies in Logic, Grammar and Rhetoric

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“…The aim in this study was to assess the clinical evolution of 234 hospitalized patients due to the The participants' characteristics regarding the predominance of male and elderly patients is similar to other studies of cardiac patients (8)(9)(10) . These variables are strongly associated with coronary patients' clinical evolution and mortality due to ACS.…”

Section: Discussionmentioning

confidence: 96%

Clinical evolution of patients hospitalized due to the first episode of Acute Coronary Syndrome

Gil¹,

Dessotte²,

Schmidt

et al. 2012

Rev. Latino-Am. Enfermagem

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AIM: to assess the clinical evolution of patients hospitalized due to the first episode of Acute Coronary Syndrome (ACS) according to its clinical manifestation. METHODS: data were collected from 234 patients, hospitalized between May 2006 and July 2009 due to the first episode of an ACS, by consulting their medical records. RESULTS: 234 patients were hospitalized, 140 (59.8%) due to Acute Myocardial Infarction (AMI). In the group with AMI, 19.3% presented complications, against 12.8% in the group with Unstable Angina (UA) (p=0.19). Angioplasty levels were higher among patients with AMI than with UA (p=0.02) and coronary artery bypass graft surgery was more frequent among UA patients (p=0.03). The majority (227; 97%) survived after the coronary event. Among the seven patients who died during the hospitalization, four had AMI (2.9%) and three UA (3.2%). CONCLUSIONS: A larger number of complications were found among infarction victims and the accomplishment of coronary artery bypass graft surgery differed between the groups.

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“…Thus, patients with a substantial risk of recurrent events have an important unmet need for better secondary prevention. 28 A combination of antiplatelet and anticoagulant agents seems to be an attractive approach. However, such broad antithrombotic therapy may also pose an unacceptable risk of bleeding.…”

Section: Discussionmentioning

confidence: 99%

Apixaban with Antiplatelet Therapy after Acute Coronary Syndrome

Alexander

Lopes

James³

et al. 2011

N Engl J Med

910

532

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Underestimated and under-recognized: the late consequences of acute coronary syndrome (GRACE UK-Belgian Study)

Cited by 387 publications

References 22 publications

Limitations of Cox Proportional Hazards Analysis in Mortality Prediction of Patients with Acute Coronary Syndrome

Limitations of Cox Proportional Hazards Analysis in Mortality Prediction of Patients with Acute Coronary Syndrome

Clinical evolution of patients hospitalized due to the first episode of Acute Coronary Syndrome

Apixaban with Antiplatelet Therapy after Acute Coronary Syndrome

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