Effect of myocardial revascularization upon long-term prognosis of patients with acute coronary syndrome and concomitant dıseases
The aim – to assess the prognostic effect of myocardial revascularization in patients with acute coronary syndrome (ACS) with comorbidity or multimorbidity. Materials and methods. Event-free survival analysis according to simplified comorbidity index and treatment strategy of 337 consecutive patie...
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TOV Chetverta Khvylia
2019-06-01
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| Series: | Кардіохірургія та інтервенційна кардіологія |
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| Online Access: | http://www.csic.com.ua/images/pdf/2019/2-2019/effect-of-myocardial-revascularization-upon-long-term-prognosis-of-patients-with-acute-coronary-syndrome.pdf |
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| _version_ | 1832557811126501376 |
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| author | R.R. Komorovsky |
| author_facet | R.R. Komorovsky |
| author_sort | R.R. Komorovsky |
| collection | DOAJ |
| description | The aim – to assess the prognostic effect of myocardial revascularization in patients with acute coronary syndrome (ACS) with comorbidity or multimorbidity.
Materials and methods. Event-free survival analysis according to simplified comorbidity index and treatment strategy of 337 consecutive patients with ACS using a composite endpoint of cardiac death and nonfatal myocardial infarction.
Results. A total of 150 (45 %) patients were found to have comorbid conditions. Among them, the simplified comorbidity index (SCI) was 0 points in 187 (55 %), 1 – in 71 (21 %), ≥ 2 – in 79 (23 %) patients. During a median follow-up of 19 months, 29 (9 %) patients experienced a composite endpoint: 14 (4 %) cardiac deaths and 15 (5 %) nonfatal myocardial infarctions. A significant linear trend between SCI and event rate was observed (χ2 = 14.59, р = 0.0001). The prognostic effect of myocardial revascularization was not significantly different from the effect of conservative treatment (hazard ratio (HR) 0.75, 95 % confidence interval (CІ) 0.16–3.33, р = 0.68 in patients with a SCI = 0 points, HR 1.71, 95 % CІ 0.25–10.20, р = 0.61 in patients with a SCI = 1, and HR 0.65, 95 % CІ 0.23–1.284, р = 0.42 in patients with a SCI ≥ 2. Left ventricular ejection fraction, peripheral artery disease and SCI ≥ 2 predicted cardiac events in the study population.
Conclusions. In the present study, invasive strategy as compared to the conservative treatment in patients with ACS with comorbidity or multimorbidity did not modify the long-term composite outcome in terms of cardiac death and nonfatal myocardial infarction |
| format | Article |
| id | doaj-art-16686dad610a41c5af1bde3966535cc1 |
| institution | Kabale University |
| issn | 2305-3127 |
| language | English |
| publishDate | 2019-06-01 |
| publisher | TOV Chetverta Khvylia |
| record_format | Article |
| series | Кардіохірургія та інтервенційна кардіологія |
| spelling | doaj-art-16686dad610a41c5af1bde3966535cc12025-02-03T02:02:13ZengTOV Chetverta KhvyliaКардіохірургія та інтервенційна кардіологія2305-31272019-06-012313810.31928/2305-3127-2019.2.3138Effect of myocardial revascularization upon long-term prognosis of patients with acute coronary syndrome and concomitant dıseasesR.R. Komorovsky0I. Horbachevsky Ternopil National Medical University, Ternopil, UkraineThe aim – to assess the prognostic effect of myocardial revascularization in patients with acute coronary syndrome (ACS) with comorbidity or multimorbidity. Materials and methods. Event-free survival analysis according to simplified comorbidity index and treatment strategy of 337 consecutive patients with ACS using a composite endpoint of cardiac death and nonfatal myocardial infarction. Results. A total of 150 (45 %) patients were found to have comorbid conditions. Among them, the simplified comorbidity index (SCI) was 0 points in 187 (55 %), 1 – in 71 (21 %), ≥ 2 – in 79 (23 %) patients. During a median follow-up of 19 months, 29 (9 %) patients experienced a composite endpoint: 14 (4 %) cardiac deaths and 15 (5 %) nonfatal myocardial infarctions. A significant linear trend between SCI and event rate was observed (χ2 = 14.59, р = 0.0001). The prognostic effect of myocardial revascularization was not significantly different from the effect of conservative treatment (hazard ratio (HR) 0.75, 95 % confidence interval (CІ) 0.16–3.33, р = 0.68 in patients with a SCI = 0 points, HR 1.71, 95 % CІ 0.25–10.20, р = 0.61 in patients with a SCI = 1, and HR 0.65, 95 % CІ 0.23–1.284, р = 0.42 in patients with a SCI ≥ 2. Left ventricular ejection fraction, peripheral artery disease and SCI ≥ 2 predicted cardiac events in the study population. Conclusions. In the present study, invasive strategy as compared to the conservative treatment in patients with ACS with comorbidity or multimorbidity did not modify the long-term composite outcome in terms of cardiac death and nonfatal myocardial infarctionhttp://www.csic.com.ua/images/pdf/2019/2-2019/effect-of-myocardial-revascularization-upon-long-term-prognosis-of-patients-with-acute-coronary-syndrome.pdfacute coronary syndromecomorbiditymultimorbiditysurvivalrevascularization. |
| spellingShingle | R.R. Komorovsky Effect of myocardial revascularization upon long-term prognosis of patients with acute coronary syndrome and concomitant dıseases Кардіохірургія та інтервенційна кардіологія acute coronary syndrome comorbidity multimorbidity survival revascularization. |
| title | Effect of myocardial revascularization upon long-term prognosis of patients with acute coronary syndrome and concomitant dıseases |
| title_full | Effect of myocardial revascularization upon long-term prognosis of patients with acute coronary syndrome and concomitant dıseases |
| title_fullStr | Effect of myocardial revascularization upon long-term prognosis of patients with acute coronary syndrome and concomitant dıseases |
| title_full_unstemmed | Effect of myocardial revascularization upon long-term prognosis of patients with acute coronary syndrome and concomitant dıseases |
| title_short | Effect of myocardial revascularization upon long-term prognosis of patients with acute coronary syndrome and concomitant dıseases |
| title_sort | effect of myocardial revascularization upon long term prognosis of patients with acute coronary syndrome and concomitant diseases |
| topic | acute coronary syndrome comorbidity multimorbidity survival revascularization. |
| url | http://www.csic.com.ua/images/pdf/2019/2-2019/effect-of-myocardial-revascularization-upon-long-term-prognosis-of-patients-with-acute-coronary-syndrome.pdf |
| work_keys_str_mv | AT rrkomorovsky effectofmyocardialrevascularizationuponlongtermprognosisofpatientswithacutecoronarysyndromeandconcomitantdıseases |