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Incremental prognos...
Incremental prognostic value of coronary and systemic atherosclerosis after myocardial infarction
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- Calais, Fredrik, 1971- (författare)
- Department of Cardiology, Örebro University Hospital, Örebro, Sweden; Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden,Örebro Univ, Fac Hlth, Dept Cardiol, Örebro, Sweden
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- Östman, Maja Eriksson (författare)
- Department of Cardiology, Örebro, Sweden; , Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden,Örebro Univ, Fac Hlth, Dept Cardiol, Örebro, Sweden
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- Hedberg, P (författare)
- Uppsala universitet,Centrum för klinisk forskning, Västerås,Västmanland Cty Hosp, Dept Clin Physiol, Västerås, Sweden
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- Rosenblad, Andreas (författare)
- Centre for Clinical Research, Uppsala University Västmanland County Hospital, Västerås, Sweden
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- Leppert, Jerzy (författare)
- Uppsala universitet,Centrum för klinisk forskning, Västerås
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- Fröbert, Ole, 1964- (författare)
- Örebro universitet,Institutionen för medicinska vetenskaper,Department of Cardiology,Örebro Univ, Fac Hlth, Dept Cardiol, Örebro, Sweden
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- Karlsson, Andreas, 1973- (författare)
- Uppsala universitet,Centrum för klinisk forskning, Västerås
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(creator_code:org_t)
- Elsevier, 2018
- 2018
- Engelska.
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Ingår i: International Journal of Cardiology. - : Elsevier. - 0167-5273 .- 1874-1754. ; 261, s. 6-11
- Relaterad länk:
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Abstract
Ämnesord
Stäng
- Background: The role of systemic atherosclerosis in myocardial infarction (MI) patients is not fully understood. We investigated the incremental prognostic value of coronary and systemic atherosclerosis after acute MI by estimating extra-cardiac artery disease (ECAD) and extent of coronary atherosclerosis.Methods and results: The study included 544 prospective MI patients undergoing coronary angiography. For all patients, the longitudinal coronary atherosclerotic extent, expressed as Sullivan extent score (SES) was calculated. In addition, the patients underwent non-invasive screening for ECAD in the carotid, aortic, renal and lower limb. SES was found to be associated with ECAD independent of baseline clinical parameters [adjusted odds ratio (OR) 1.04 95% confidence interval (CI) 1.02-1.06, P < 0.001]. Extensive systemic atherosclerosis, defined as the combination of extensive coronary disease (SES >= 17) and ECAD, was associated with higher risk for all-cause mortality compared to limited systemic atherosclerosis (SES < 17 and no ECAD) (hazard ratio [HR] 2.9 95% CI 1.9-4.5, P < 0.001, adjusted for Global Registry of Acute Coronary Events risk score parameters 1.8, 95% CI 1.1-3.0, P = 0.019). The risk for the composite endpoint of cardiovascular death or hospitalization was significantly higher in patients with extensive systemic atherosclerosis compared to patients with limited systemic atherosclerosis (HR 3.1, 95% CI 2.1-4.7, P < 0.001, adjusted HR 1.9, 95% CI 1.2-3.1, P < 0.004).Conclusions: Visual estimation of the longitudinal coronary atherosclerotic extent at the time of MI predicts ECAD. Coexistence of extensive coronary disease and ECAD defines a group with particularly poor prognosis after MI.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- Atherosclerosis
- Myocardial infarction
- Coronary artery disease
- Extra-cardiac artery disease
- Prognosis
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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