PMID- 28052754 OWN - NLM STAT- MEDLINE DCOM- 20171003 LR - 20181113 IS - 1471-2261 (Electronic) IS - 1471-2261 (Linking) VI - 17 IP - 1 DP - 2017 Jan 4 TI - The burden of major adverse cardiac events in patients with coronary artery disease. PG - 1 LID - 10.1186/s12872-016-0436-7 [doi] LID - 1 AB - 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. FAU - Tsai, I-Ting AU - Tsai IT AD - Department of Emergency, E-Da Hospital, I-Shou University, Kaohsiung, 82445, Taiwan. AD - Department of Nursing, I-Shou University, Kaohsiung, 82445, Taiwan. FAU - Wang, Chao-Ping AU - Wang CP AD - Division of Cardiology, E-Da Hospital, I-Shou University, No. 1, Yi-Da Rd, Jiau-Shu Village, Yan-Chao District, Kaohsiung, 82445, Taiwan. AD - School of Medicine for International Students, E-Da Hospital, I-Shou University, Kaohsiung, 82445, Taiwan. FAU - Lu, Yung-Chuan AU - Lu YC AD - Division of Endocrinology and Metabolism, E-Da Hospital, I-Shou University, Kaohsiung, 82445, Taiwan. AD - School of Medicine for International Students, E-Da Hospital, I-Shou University, Kaohsiung, 82445, Taiwan. FAU - Hung, Wei-Chin AU - Hung WC AD - Division of Cardiology, E-Da Hospital, I-Shou University, No. 1, Yi-Da Rd, Jiau-Shu Village, Yan-Chao District, Kaohsiung, 82445, Taiwan. FAU - Wu, Cheng-Ching AU - Wu CC AD - Division of Cardiology, E-Da Hospital, I-Shou University, No. 1, Yi-Da Rd, Jiau-Shu Village, Yan-Chao District, Kaohsiung, 82445, Taiwan. AD - Department of Biomedical Engineering, National Cheng Kung University, Tainan, 70101, Taiwan. FAU - Lu, Li-Fen AU - Lu LF AD - Division of Cardiac Surgery, Department of Surgery, E-Da Hospital, I-Shou University, Kaohsiung, 82445, Taiwan. FAU - Chung, Fu-Mei AU - Chung FM AD - Division of Cardiology, E-Da Hospital, I-Shou University, No. 1, Yi-Da Rd, Jiau-Shu Village, Yan-Chao District, Kaohsiung, 82445, Taiwan. FAU - Hsu, Chia-Chang AU - Hsu CC AD - Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, 82445, Taiwan. FAU - Lee, Yau-Jiunn AU - Lee YJ AD - Lee's Endocrinology Clinic, Pingtung, 90000, Taiwan. FAU - Yu, Teng-Hung AU - Yu TH AD - Division of Cardiology, E-Da Hospital, I-Shou University, No. 1, Yi-Da Rd, Jiau-Shu Village, Yan-Chao District, Kaohsiung, 82445, Taiwan. gene6623@yahoo.com.tw. LA - eng PT - Journal Article PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20170104 PL - England TA - BMC Cardiovasc Disord JT - BMC cardiovascular disorders JID - 100968539 RN - 268B43MJ25 (Uric Acid) SB - IM MH - Acute Coronary Syndrome/diagnosis/*epidemiology/mortality/therapy MH - Adult MH - Aged MH - Aged, 80 and over MH - Area Under Curve MH - Chi-Square Distribution MH - Comorbidity MH - Coronary Artery Bypass MH - Coronary Artery Disease/diagnosis/*epidemiology/mortality/therapy MH - Female MH - Glomerular Filtration Rate MH - Hospitalization MH - Humans MH - Hypertension/epidemiology MH - Hyperuricemia/blood/epidemiology MH - Kidney/physiopathology MH - Kidney Diseases/epidemiology/physiopathology MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Myocardial Infarction/diagnosis/*epidemiology/mortality/therapy MH - Percutaneous Coronary Intervention/adverse effects/instrumentation/mortality MH - Predictive Value of Tests MH - Proportional Hazards Models MH - Prospective Studies MH - ROC Curve MH - Recurrence MH - Retreatment MH - Risk Assessment MH - Risk Factors MH - Socioeconomic Factors MH - Stents MH - Taiwan/epidemiology MH - Time Factors MH - Treatment Outcome MH - Uric Acid/blood PMC - PMC5210314 OTO - NOTNLM OT - Coronary artery disease OT - Major adverse cardiovascular events OT - Predictive factors EDAT- 2017/01/06 06:00 MHDA- 2017/10/04 06:00 PMCR- 2017/01/04 CRDT- 2017/01/06 06:00 PHST- 2016/03/31 00:00 [received] PHST- 2016/12/07 00:00 [accepted] PHST- 2017/01/06 06:00 [entrez] PHST- 2017/01/06 06:00 [pubmed] PHST- 2017/10/04 06:00 [medline] PHST- 2017/01/04 00:00 [pmc-release] AID - 10.1186/s12872-016-0436-7 [pii] AID - 436 [pii] AID - 10.1186/s12872-016-0436-7 [doi] PST - epublish SO - BMC Cardiovasc Disord. 2017 Jan 4;17(1):1. doi: 10.1186/s12872-016-0436-7.