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Predictors of Major Adverse Cardiovascular and Cerebrovascular Events After Acute Coronary Syndromes: A Retrospective
Insights
Predictors of major adverse cerebrovascular and cardiovascular events (MACCE) in first-time acute coronary syndrome (ACS) patients include male sex, chronic kidney disease, atrial fibrillation, statin use, and reduced independence in daily living. These findings are crucial for managing ACS in an aging population.
Area of Science:
- Cardiology
- Geriatrics
- Public Health
Background:
- Japan's population is rapidly aging, increasing the need to understand cardiovascular risks.
- Predictors for major adverse cerebrovascular and cardiovascular events (MACCE) in first-time acute coronary syndrome (ACS) patients are not well-established.
Purpose of the Study:
- To identify clinical predictors of MACCE in patients experiencing their first onset of ACS.
- To inform care strategies for ACS patients in an aging demographic.
Main Methods:
- Retrospective analysis of 3,373 patients with first-onset ACS from the Yokohama Original Medical Database (April 2014 - March 2016).
- Investigation of MACCE incidence from June 2014 to March 2018.
- Classification of patients' independence of daily living (IDL) into reference, mild, and severe categories.
Main Results:
- Multivariate logistic regression identified key predictors of MACCE.
- Lower IDL significantly increased MACCE risk: odds ratios of 1.35 for mild and 2.12 for severe impairment compared to reference (P for trend < 0.001).
Conclusions:
- Male sex, chronic kidney disease, atrial fibrillation, statin use (both high- and low-intensity), and lower IDL are significant predictors of MACCE in first-onset ACS patients.
- Further research is needed to develop interventions targeting these identified predictors.
Objectives:
Despite the rapid aging of the population in Japan, clinical predictors for major adverse cerebrovascular and cardiovascular events (MACCE) in patients with new onset of acute coronary syndromes (ACS) have not been well studied. This study therefore aimed to identify the predictors of MACCE in the first onset of ACS patients requiring care.
Materials And Methods:
Using the Yokohama Original Medical Database, we identified 3,373 patients who experienced a first onset of ACS and had certified care information from April 2014 to March 2016. The incidence proportion of MACCE from June 2014 to March 2018 was retrospectively investigated. Each patient's independence of daily living (IDL) was classified as one of three categories (reference, mild and severe).
Results:
Predictors of MACCE were identified using multivariate logistic regression analysis. Impaired IDL was associated with increased MACCE, with adjusted odds ratios for reference, mild and severe of 1.00, 1.35 (95% confidence intervals 1.14-1.60) and 2.12 (95% confidence intervals 1.61-2.80; P for trend < 0.001), respectively.
Conclusions:
This study revealed that male sex, chronic kidney disease, atrial fibrillation, high-intensity statin use, low-intensity statin use, and lower IDL (representing less independence) were the predictors of MACCE requiring care for a first onset of ACS. Further research will be required to understand the results of interventions for the identified predictors of MACCE.
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