Worse long-term prognosis in myocardial infarction occurring at weekends or public holidays with insight into myocardial infarction with nonobstructive coronary arteries

Stępień, Konrad; Nowak, Karol; Nessler, Jadwiga; Zalewski, J

doi:10.20452/pamw.15615

Cited by 8 publications

(11 citation statements)

References 41 publications

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“…In case of suspicious borderline obstructive lesions between 40% and 70%, quantitative coronary angiography (QCA Quantcor, Siemens, Germany) was performed for detailed assessment. Lesions narrowing a coronary artery by less than 50% were defined as non-obstructive according to the current guidelines [ 39 ] and patients were presumed as MINOCA [ 40 , 41 ].…”

Section: Methodsmentioning

confidence: 99%

Statin Use in Cancer Patients with Acute Myocardial Infarction and Its Impact on Long-Term Mortality

et al. 2022

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Statin use and its impact on long-term clinical outcomes in active cancer patients following acute myocardial infarction (MI) remains insufficiently elucidated. Of the 1011 consecutive acute MI patients treated invasively between 2012 and 2017, cancer was identified in 134 (13.3%) subjects. All patients were observed within a median follow-up of 69.2 (37.8–79.9) months. On discharge, statins were prescribed less frequently in MI patients with cancer as compared to the non-cancer MI population (79.9% vs. 91.4%, p < 0.001). The most common statin in both groups was atorvastatin. The long-term mortality was higher in MI patients not treated vs. those treated with statins, both in non-cancer (29.5%/year vs. 6.7%/year, p < 0.001) and cancer groups (53.9%/year vs. 24.9%/year, p < 0.05), respectively. Patient’s age (hazard ratio (HR) 1.04, 95% confidence interval (CI) 1.03–1.05, p < 0.001, per year), an active cancer (HR 2.42, 95% CI 1.89–3.11, p < 0.001), hemoglobin level (HR 1.14, 95% CI 1.09–1.20, p < 0.001, per 1 g/dL decrease), and no statin on discharge (HR 2.13, 95% CI 1.61–2.78, p < 0.001) independently increased long-term mortality. In MI patients, simultaneous diagnosis of an active cancer was associated with less frequently prescribed statins on discharge. Irrespective of cancer diagnosis, no statin use was found as an independent predictor of increased long-term mortality.

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Section: Methodsmentioning

confidence: 99%

Statin Use in Cancer Patients with Acute Myocardial Infarction and Its Impact on Long-Term Mortality

et al. 2022

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“…MINOCA was recognized in 72 (7.1%) subjects ( Figure 1 ) based on the universal criteria of MI (positive cardiac biomarkers rising and/or falling in serial measurements, with at least one value above the 99th percentile as the upper reference limit and at least one clinical sign of infarction). An additional inclusion criterion was a lack of obstructive lesions narrowing epicardial coronary segments by more than 50% in angiography ( 1 , 17 ). Patients with ST-segment elevation of at least 1 mm in at least two contiguous leads were classified as ST-segment elevation MI (STEMI), whereas patients without ST-segment elevation on admission were diagnosed as non-ST-segment elevation MI (NSTEMI) ( 18 ).…”

Section: Methodsmentioning

confidence: 99%

Clinical Characteristics and Long-Term Outcomes of MINOCA Accompanied by Active Cancer: A Retrospective Insight Into a Cardio-Oncology Center Registry

Stępień

Nowak

Szlósarczyk

et al. 2022

Front. Cardiovasc. Med.

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BackgroundClinical characteristics and long-term outcomes of patients with myocardial infarction with non-obstructive coronary arteries (MINOCA) and cancer are insufficiently elucidated.ObjectivesWe sought to characterize these patients hospitalized in a tertiary cardio-oncology center and to find the potential determinants affecting their long-term mortality.MethodsMINOCA was diagnosed in 72 of the 1,011 patients with consecutive myocardial infarction who underwent coronary angiography. Mortality rates and their determinants were analyzed within a median follow-up of 69.2 (37.8–79.9) months.ResultsActive cancer was identified in 21 (29.2%) of patients with MINOCA and in 113 (12.0%) patients with myocardial infarction and obstructive coronary artery disease (MI-CAD) (p < 0.001). MINOCA patients with cancer were characterized by a higher incidence of anemia (47.6 vs. 21.6%, p = 0.03) and more frequently Takotsubo syndrome (19.1 vs. 2.0%, p = 0.01) than in non-cancer MINOCA. The troponin T/hemoglobin ratio was higher in both cancer MINOCA and MI-CAD groups when compared with their respective non-cancer patients (both p < 0.05). The age and sex-standardized mortality rates were significantly higher in cancer MINOCA (26.7%/year) when compared with non-cancer MINOCA (2.3%/year, p = 0.002) and in cancer MI-CAD (25.0%/year) vs. non-cancer MI-CAD (3.7%/year, p < 0.001). Active cancer (HR 3.12, 95% CI 2.41–4.04) was independently associated with higher long-term mortality, while higher hemoglobin levels (HR 0.93, 95% CI 0.88–0.99, per g/dl) and a MINOCA diagnosis (HR 0.69, 95% CI 0.47–0.97) improved long-term survival.ConclusionPatients with MINOCA were comorbid with cancer more frequently than MI-CAD. In turn, an active malignancy was associated with an unfavorable long-term survival both in MI-CAD population and in patients with MINOCA.

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“…Despite similar cardiovascular risk factors, obese patients may represent a considerable difference in cardiovascular risk profile and clinical prognosis [1,3]. A recent large body of evidence suggests that the adipose quantity, distribution, location, and bioactive function of adipocytes in the total body and specific fat depots are strongly associated with the risk of a new-onset DM and total cardiovascular risk [1,[4][5][6].…”

Section: Introductionmentioning

confidence: 99%

The cardiometabolic predictive value of anthropometric parameters, vascular ultrasound indexes and fat depots among patients with high cardiovascular risk: an 8-year prospective cohort study

Haberka¹,

Matla²,

Siniarski³

et al. 2022

Polish Archives of Internal Medicine

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Worse long-term prognosis in myocardial infarction occurring at weekends or public holidays with insight into myocardial infarction with nonobstructive coronary arteries

Cited by 8 publications

References 41 publications

Statin Use in Cancer Patients with Acute Myocardial Infarction and Its Impact on Long-Term Mortality

Statin Use in Cancer Patients with Acute Myocardial Infarction and Its Impact on Long-Term Mortality

Clinical Characteristics and Long-Term Outcomes of MINOCA Accompanied by Active Cancer: A Retrospective Insight Into a Cardio-Oncology Center Registry

The cardiometabolic predictive value of anthropometric parameters, vascular ultrasound indexes and fat depots among patients with high cardiovascular risk: an 8-year prospective cohort study

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