Development of one-year major adverse cardiac events risk index in patients with acute coronary syndrome and diabetes mellitus who underwent percutaneous coronary intervention

Background/Aim. Patients with acute coronary syndrome (ACS) and diabetes mellitus (DM) have an increased risk of major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI), which is not estimated sufficiently-multidimensionally in terms of type and severity of the ACS...

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Main Authors: Mirković Marija, Nedeljković Milan, Ružičić Dušan, Vuković Mira
Format: Article
Language:English
Published: Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade 2020-01-01
Series:Vojnosanitetski Pregled
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Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2020/0042-84501900026M.pdf
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author Mirković Marija
Nedeljković Milan
Ružičić Dušan
Vuković Mira
author_facet Mirković Marija
Nedeljković Milan
Ružičić Dušan
Vuković Mira
author_sort Mirković Marija
collection DOAJ
description Background/Aim. Patients with acute coronary syndrome (ACS) and diabetes mellitus (DM) have an increased risk of major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI), which is not estimated sufficiently-multidimensionally in terms of type and severity of the ACS and/or DM and angiographic findings. The study was intended to validate and develop an index of metabolic, angiographic, anatomic and clinical risk factors for one-year MACE after conducted PCI in patients with ACS and DM. Methods. A prospective cross-sectional study was performed in patients with DM and ACS. In the PCI period the following risk factors were recorded: 1) age and metabolic variables – glycosylated hemoglobin (HbA1c), total cholesterol, and triglycerides levels in the blood; 2) endocrinological variables – DM therapy and type of DM; 3) ACS modality; 4) radiological/anatomical variable – SYNTAX score, and 5) clinical variables in modified age, creatinine, ejection fraction (ACEF) score. One-year MACE were recorded. Results. From a total of 136 consecutive patients, 55 of them developed at least one MACE in one-year follow-up. A high predictive risk index was evaluated that assessed particular or associated risks for one-year MACE (c statistic = 0.879) in the study population, defined by: SYNTAX score > 21, modified ACEF score > 1.38, HbA1c ≥ 8%, triglyceridemia ≥ 2.3 mmol/L in patients with insulin therapy, and ACS modality – unstable angina pectoris. The constructed risk index for one-year MACE (MACERI) had better predictive characteristics than SYNTAX score (c statistic = 0.798), as well as ACF score (c statistic = 0.744). Conclusion. MACERI can potentially have great application in future risk factors studies for one-year MACE in patients with DM and ACS who underwent PCI, because with it the effects of these factors are measured multidimensionally at valid and accurate manner.
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spelling doaj-art-4a8151e4e0c2471a8afb191cdcbdeab22025-08-20T03:36:35ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202020-01-0177111192120010.2298/VSP181102026M0042-84501900026MDevelopment of one-year major adverse cardiac events risk index in patients with acute coronary syndrome and diabetes mellitus who underwent percutaneous coronary interventionMirković Marija0Nedeljković Milan1Ružičić Dušan2Vuković Mira3General Hospital Valjevo, Department of Cardiology and Invasive Cardiology, Valjevo, SerbiaClinical Center of Serbia, Clinic of Cardiology, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, SerbiaGeneral Hospital Valjevo, Department of Cardiology and Invasive Cardiology, Valjevo, SerbiaGeneral Hospital Valjevo, Department of Cardiology and Invasive Cardiology, Valjevo, SerbiaBackground/Aim. Patients with acute coronary syndrome (ACS) and diabetes mellitus (DM) have an increased risk of major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI), which is not estimated sufficiently-multidimensionally in terms of type and severity of the ACS and/or DM and angiographic findings. The study was intended to validate and develop an index of metabolic, angiographic, anatomic and clinical risk factors for one-year MACE after conducted PCI in patients with ACS and DM. Methods. A prospective cross-sectional study was performed in patients with DM and ACS. In the PCI period the following risk factors were recorded: 1) age and metabolic variables – glycosylated hemoglobin (HbA1c), total cholesterol, and triglycerides levels in the blood; 2) endocrinological variables – DM therapy and type of DM; 3) ACS modality; 4) radiological/anatomical variable – SYNTAX score, and 5) clinical variables in modified age, creatinine, ejection fraction (ACEF) score. One-year MACE were recorded. Results. From a total of 136 consecutive patients, 55 of them developed at least one MACE in one-year follow-up. A high predictive risk index was evaluated that assessed particular or associated risks for one-year MACE (c statistic = 0.879) in the study population, defined by: SYNTAX score > 21, modified ACEF score > 1.38, HbA1c ≥ 8%, triglyceridemia ≥ 2.3 mmol/L in patients with insulin therapy, and ACS modality – unstable angina pectoris. The constructed risk index for one-year MACE (MACERI) had better predictive characteristics than SYNTAX score (c statistic = 0.798), as well as ACF score (c statistic = 0.744). Conclusion. MACERI can potentially have great application in future risk factors studies for one-year MACE in patients with DM and ACS who underwent PCI, because with it the effects of these factors are measured multidimensionally at valid and accurate manner.http://www.doiserbia.nb.rs/img/doi/0042-8450/2020/0042-84501900026M.pdfcoronary artery diseasecoronary angiographydiabetes mellituscomorbiditycardiovascular diseasesacute diseaserisk factors
spellingShingle Mirković Marija
Nedeljković Milan
Ružičić Dušan
Vuković Mira
Development of one-year major adverse cardiac events risk index in patients with acute coronary syndrome and diabetes mellitus who underwent percutaneous coronary intervention
Vojnosanitetski Pregled
coronary artery disease
coronary angiography
diabetes mellitus
comorbidity
cardiovascular diseases
acute disease
risk factors
title Development of one-year major adverse cardiac events risk index in patients with acute coronary syndrome and diabetes mellitus who underwent percutaneous coronary intervention
title_full Development of one-year major adverse cardiac events risk index in patients with acute coronary syndrome and diabetes mellitus who underwent percutaneous coronary intervention
title_fullStr Development of one-year major adverse cardiac events risk index in patients with acute coronary syndrome and diabetes mellitus who underwent percutaneous coronary intervention
title_full_unstemmed Development of one-year major adverse cardiac events risk index in patients with acute coronary syndrome and diabetes mellitus who underwent percutaneous coronary intervention
title_short Development of one-year major adverse cardiac events risk index in patients with acute coronary syndrome and diabetes mellitus who underwent percutaneous coronary intervention
title_sort development of one year major adverse cardiac events risk index in patients with acute coronary syndrome and diabetes mellitus who underwent percutaneous coronary intervention
topic coronary artery disease
coronary angiography
diabetes mellitus
comorbidity
cardiovascular diseases
acute disease
risk factors
url http://www.doiserbia.nb.rs/img/doi/0042-8450/2020/0042-84501900026M.pdf
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AT ruzicicdusan developmentofoneyearmajoradversecardiaceventsriskindexinpatientswithacutecoronarysyndromeanddiabetesmellituswhounderwentpercutaneouscoronaryintervention
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