Predictors of Five-Year Outcomes in Patients with Acute Coronary Syndromes.

IF 2.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Development and Disease Pub Date : 2025-06-18 DOI:10.3390/jcdd12060234

Luca Di Vito, Giancarla Scalone, Federico Di Giusto, Filippo Bruscoli, Simona Silenzi, Adelina Selimi, Arianna Massari, Domenico Delfino, Federico Guerra, Pierfrancesco Grossi

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引用次数: 0

Abstract

Background: Residual risk after acute coronary syndromes (ACSs) continues to affect prognosis. We investigated the impact of female sex, non-ST-segment-elevation myocardial infarction (NSTEMI), diabetes mellitus (DM), and chronic kidney disease (CKD) on coronary atherosclerosis extent, culprit stenosis location, and bio-humoral data. The rate of both major adverse cardiovascular events (MACE) and non-fatal recurrent coronary events (RCE) was additionally evaluated.

Methods: We enrolled 1404 ACS patients and followed them for up to 5 years. Coronary culprit and non-culprit stenoses were analyzed using angiography. Biohumoral data was assessed at admission and at 1 month and 12 months after discharge. Patients were compared based on sex, NSTEMI, DM, and CKD presence.

Results: NSTEMI patients had a higher number of total coronary stenoses (3.5 vs. 3.3, p = 0.013) and non-culprit stenoses (2.3 vs. 1.6, p = 0.0001). Non-culprit percent stenosis was significantly greater in NSTEMI as compared to STEMI patients (57.9% vs. 47.1%, p = 0.0001). DM patients had a higher frequency of bifurcation lesions (41% vs. 25%, p = 0.0001). CKD patients showed a higher prevalence of left main disease (3.4% vs. 1.5%, p = 0.038). Female patients had higher LDL-cholesterol values at 1 month and 12 months. NSTEMI, DM, and creatinine level were independent predictors of MACE. NSTEMI patients had an increased risk of non-fatal RCE.

Conclusions: NSTEMI, DM, and creatinine levels at admission were independent predictors of MACE in the first 5 years after an ACS.

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急性冠脉综合征患者5年预后的预测因素。

背景：急性冠脉综合征（ACSs）后的残留风险继续影响预后。我们研究了女性、非st段抬高型心肌梗死（NSTEMI）、糖尿病（DM）和慢性肾脏疾病（CKD）对冠状动脉粥样硬化程度、罪魁祸首狭窄位置和生物体液数据的影响。另外还评估了主要不良心血管事件（MACE）和非致死性复发冠状动脉事件（RCE）的发生率。方法：我们招募了1404例ACS患者，随访时间长达5年。冠脉造影分析冠脉罪魁祸首和非罪魁祸首狭窄。在入院时、出院后1个月和12个月评估生物体液数据。患者根据性别、非stemi、DM和CKD进行比较。结果：NSTEMI患者冠脉总狭窄（3.5 vs 3.3, p = 0.013）和非罪魁祸首狭窄（2.3 vs. 1.6, p = 0.0001）数量更高。非罪魁祸首狭窄百分比在NSTEMI患者中明显高于STEMI患者（57.9% vs. 47.1%, p = 0.0001）。DM患者出现分叉病变的频率更高（41% vs. 25%, p = 0.0001）。CKD患者左主干病变的患病率较高（3.4% vs. 1.5%, p = 0.038）。女性患者在1个月和12个月时ldl -胆固醇值较高。NSTEMI、DM和肌酐水平是MACE的独立预测因子。NSTEMI患者发生非致死性RCE的风险增加。结论：入院时的NSTEMI、DM和肌酐水平是ACS后前5年MACE的独立预测因子。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cardiovascular Development and Disease CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

2.60

自引率

12.50%

发文量

381