scholarly journals Long-term outcomes of patients with multivessel coronary artery disease presenting non-ST-segment elevation acute coronary syndromes

2013 ◽  
Author(s):  
Piotr Desperak ◽  
Michał Hawranek ◽  
Paweł Gąsior ◽  
Aneta Desperak ◽  
Andrzej Lekston ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Acute Coronary Syndromes ◽  
Multivessel Coronary Artery Disease ◽  
Long Term Outcomes ◽  
St Segment Elevation ◽  
St Segment ◽  
Coronary Syndromes ◽  
Artery Disease

P4572Lipoprotein(a) is not associated with survival after acute coronary syndromes

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
C Roth ◽  
D Dalos ◽  
C Gangl ◽  
K Krychtiuk ◽  
L Schrutka ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Acute Coronary Syndromes ◽  
Total Mortality ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Coronary Syndromes ◽  
Artery Disease

Abstract Aims Lipoprotein(a) [Lp(a)] is associated with coronary artery disease in population studies, however studies on its predictive value in patients with established cardiovascular disease, in particular after acute coronary syndromes (ACS), are conflicting. The aim of this study was to investigate whether Lp(a) is associated with survival after ACS. Methods and results We analyzed 4469 consecutive patients that underwent coronary angiography for ACS. Lp(a) measurement at time of ACS was available in 1245 patients and median follow-up for cardiovascular and total mortality was 5.0 (IQR 3.2–8.0) years. 655 (52.6%) presented with ST-segment elevation myocardial infarction (STEMI), 424 (34.1%) with Non-ST-segment elevation myocardial infarction (NSTEMI) and 166 (13.3%) underwent coronary angiography for unstable angina. Cardiovascular mortality was 9.1% and total mortality was 15.7%. Patients were stratified into four groups to their Lp(a) levels. (≤15 mg/dL, >15–30 mg/dL, >30–60 mg/dL, and >60 mg/dL). Multivessel disease was significantly more common in patients with Lp(a) >60 mg/dL (p<0.05). Increased levels of Lp(a) were not associated with cardiovascular mortality (HR compared with Lp(a) ≤15 mg/dL were 1.2, 1.2, and 1.0, respectively; p=0.69) and not with total mortality (HR compared with Lp(a) ≤15 mg/dL were 1.2, 1.2, and 1.2, respectively; p=0.46). Central Figure Conclusion Lp(a) levels at time of ACS were neither associated with cardiovascular nor with total mortality. Although Lp(a) has been shown to be associated with incidence of coronary artery disease, this study does not support any role of Lp(a) as a risk factor after ACS. This should be taken into account for development of outcome studies for agents targeting Lp(a) plasma levels.

Abstract 5598: Angiographic Evidence of Early Coronary Artery Disease and Inceased Risk of Mortality in Smokers with Non-ST-Segment Elevation Acute Coronary Syndromes: An Analysis of the ACUITY Trial

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Jason O Robertson ◽  
Ramin Ebrahimi ◽  
Alexandra J Lansky ◽  
Roxana Mehran ◽  
Gregg W Stone ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Major Bleeding ◽  
Acute Coronary Syndromes ◽  
Smoking Status ◽  
St Segment Elevation ◽  
St Segment ◽  
Acute Mi ◽  
Coronary Syndromes ◽  
Artery Disease

To determine the relationship between smoking and outcomes in a contemporary population of patients with non-ST-elevation acute coronary syndromes (NSTE-ACS). Smoking has been associated with the “paradox” of reduced mortality following acute MI. This is thought to be due to favorable baseline characteristics and less diffuse CAD of smokers. In the ACUITY trial, 13,819 patients (29.1% smokers) with moderate- to high-risk NSTE-ACS underwent angiography and, if indicated, revascularization. Smokers were significantly younger and had fewer co-morbidities than nonsmokers. Incidence of death and MI were comparable at 30-days, although smokers had significantly reduced risks of 30-day major bleeding (HR=0.80, 95% CI=0.67– 0.96, p=0.016) and 1-year mortality (HR=0.797, 95% CI=0.65– 0.97, p=0.027). After multivariate correction for baseline and clinical differences, however, smoking status was no longer predictive of major bleeding (OR=1.06, 95% CI=0.85–1.32, p =0.59) and was associated with higher 1-year mortality (HR=1.38, 95% CI=1.07–1.78, p =0.013). This pattern of reversed risk following multivariable correction held true, as well, for those smokers requiring PCI. Core laboratory angiographic analysis showed that smokers and nonsmokers were comparable in terms of the extent of coronary artery disease, TIMI flow, myocardial blush and the presence of thrombi, but smokers had significantly less coronary artery calcification and fewer collaterals. In contrast to the paradox previously described in STEMI, our analysis finds smoking to be an independent predictor of higher 1-year mortality in patients presenting with NSTE-ACS, and our angiographic study demonstrates CAD disease in smokers that is comparable to nonsmokers but evident approximately one decade earlier.

scholarly journals The association of baseline N-terminal pro-B-type natriuretic peptide with short and long-term prognosis following percutaneous coronary intervention in non-ST segment elevation acute coronary syndrome with multivessel coronary artery disease: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wen-fei He ◽  
Lei Jiang ◽  
Yi-yue Chen ◽  
Yuan-hui Liu ◽  
Peng-yuan Chen ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Intervention ◽  
Multivessel Coronary Artery Disease ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Percutaneous Coronary ◽  
Artery Disease

Abstract Background Several studies have shown that N-terminal pro-B-type natriuretic peptide (NT-proBNP) is strongly correlated with the complexity of coronary artery disease and the prognosis of patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS), However, it remains unclear about the prognostic value of NT-proBNP in patients with NSTE-ACS and multivessel coronary artery disease (MCAD) undergoing percutaneous coronary intervention (PCI). Therefore, this study aimed to reveal the relationship between NT-proBNP levels and the prognosis for NSTE-ACS patients with MCAD undergoing successful PCI. Methods This study enrolled 1022 consecutive NSTE-ACS patients with MCAD from January 2010 to December 2014. The information of NT-proBNP levels was available from these patients. The primary outcome was in-hospital all-cause death. In addition, the 3-year follow-up all-cause death was also ascertained. Results A total of 12 (1.2%) deaths were reported during hospitalization. The 4th quartile group of NT-proBNP (> 1287 pg/ml) showed the highest in-hospital all-cause death rate (4.3%) (P < 0.001). Besides, logistic analyses revealed that the increasing NT-proBNP level was robustly associated with an increased risk of in-hospital all-cause death (adjusted odds ratio (OR): 2.86, 95% confidence interval (CI) = 1.16–7.03, P = 0.022). NT-proBNP was able to predict the in-hospital all-cause death (area under the curve (AUC) = 0.888, 95% CI = 0.834–0.941, P < 0.001; cutoff: 1568 pg/ml). Moreover, as revealed by cumulative event analyses, a higher NT-proBNP level was significantly related to a higher long-term all-cause death rate compared with a lower NT-proBNP level (P < 0.0001). Conclusions The increasing NT-proBNP level is significantly associated with the increased risks of in-hospital and long-term all-cause deaths among NSTE-ACS patients with MCAD undergoing PCI. Typically, NT-proBN P > 1568 pg/ml is related to the all-cause and in-hospital deaths.

Sign in / Sign up

Export Citation Format

Share Document