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BMC Cardiovascular Disorders
Published in: BMC Cardiovascular Disorders 1/2017

Open Access 01-12-2017 | Research article

The burden of major adverse cardiac events in patients with coronary artery disease

Authors: I-Ting Tsai, Chao-Ping Wang, Yung-Chuan Lu, Wei-Chin Hung, Cheng-Ching Wu, Li-Fen Lu, Fu-Mei Chung, Chia-Chang Hsu, Yau-Jiunn Lee, Teng-Hung Yu

Published in: BMC Cardiovascular Disorders | Issue 1/2017

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Abstract

Background

Patients with a history of cardiovascular disease are at high risk of developing secondary major adverse cardiac events (MACE). This study aimed to identify independent predictors of MACE after hospital admission which could be used to identify of high-risk patients who may benefit from preventive strategies.

Methods

This study included 1,520 consecutive patients with coronary artery disease (CAD) (654 with acute coronary syndrome (ACS) and 866 with elective percutaneous coronary intervention (PCI) patients) who received PCI and/or stenting. MACE was defined as all-cause mortality or rehospitalization for a cardiovascular- related illness. Cardiovascular-related illnesses included heart failure, reinfarction (nonfatal), recurrence of angina pectoris and repeat PCI or coronary artery bypass graft.

Results

During a mean follow-up period of 32 months, 558 of the 1,520 patients developed at least one MACE. Cox regression analysis showed that the baseline clinical and biochemical variables which associated with MACE were age, being illiterate, a widow or widower, and/or economically dependent, having triple vessel disease, stent implantation, anemia, and/or diabetes mellitus, waist to hip ratio (WHR), diastolic blood pressure, fasting glucose, total cholesterol, high-density lipoprotein cholesterol (HDL-C), creatinine, estimated glomerular filtration rate (eGFR), red blood cell count, hemoglobin, hematocrit, and mean corpuscular-hemoglobin concentration (MCHC) in ACS patients, and age, malnourished, and/or economically dependent, taking hypoglycemic medication, having triple vessel disease, stent implantation, anemia, diabetes mellitus, and/or hypertension, WHR, fasting glucose, HDL-C, uric acid, creatinine, eGFR, high-sensitivity C-reactive protein, mean corpuscular volume, and MCHC in elective PCI patients. Using multivariate Cox regression analysis, we found the MACE’s independent factors are triple vessel disease, stent implantation, hypertension, and eGFR in ACS patients, and having triple vessel disease, stent implantation, hypertension, and uric acid in elective PCI patients.

Conclusions

Having triple vessel disease, stent implantation, hypertension, and eGFR or uric acid independently predicted MACE in patients with CAD after long-term follow-up. Fortunately, these factors are modifiable and should be identified and monitored early.
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Metadata
Title
The burden of major adverse cardiac events in patients with coronary artery disease
Authors
I-Ting Tsai
Chao-Ping Wang
Yung-Chuan Lu
Wei-Chin Hung
Cheng-Ching Wu
Li-Fen Lu
Fu-Mei Chung
Chia-Chang Hsu
Yau-Jiunn Lee
Teng-Hung Yu
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2017
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-016-0436-7

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