Acute Coronary Syndrome Registry of High Risk Patients: 30-Day Outcome
https://doi.org/10.18087/cardio.2019.11.n723
Abstract
Aim. The aim of the study is to evaluate important additional cardiovascular (CV) risk factors of major adverse cardiac events (MACE) in patients with acute coronary syndrome (ACS) during the first 30 days after index event. Materials and methods. Overall 750 patients with ACS were enrolled in the single center prospective registry from 2012-2015yy. 569 patients received dual antiplatelet therapy and in 425 cases platelet function testing (PFT) were performed. Most of the patients characterized as high risk elderly patients with multiple CV risk factors and high comorbidity index. Results. At 30-day follow-up the mortality rate was 10,1%. Singlevariate analysis showed strong association between MACE and age, atrial fibrillation, stroke, chronic kidney disease, low ejection fraction, type 2 myocardial infarction (T2MI). Multivariate analysis showed that high-on-treatment platelet reactivity (PFT> 45%) with odds ratio 4.418 (p=0.0001), chronic kidney disease (OR 6.538 p=0.001) and T2MI (OR 1.925 p=0.0001) were significantly associated with adverse outcome. Conclusion. ACS registry showed high mortality level in real-life practice compared with randomized clinical trials due to the high prevalence of elderly patients with high comorbidity index. Patients with T2MI have significantly more severe prognosis and chronic kidney disease associated with increased MACE. PFT in this category of patients is reasonable for more accurate risk stratification.
Supporting agencies: there is not a conflict of interests
About the Authors
N. V. Lomakin
Central Clinical Hospital of the Management Affair of President RF
Russian Federation
Russian Federation
Lomakin Nikita V. – PhD, MD
Moscow
L. I. Buryachkovskaya
National Medical Research Center for Cardiology
Russian Federation
Moscow
Russian Federation
Moscow
A. B. Sumarokov
National Medical Research Center for Cardiology
Russian Federation
Moscow
Russian Federation
Moscow
A. N. Gerasimov
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Moscow
Russian Federation
Moscow
Z. A. Gabbasov
National Medical Research Center for Cardiology
Russian Federation
Moscow
Russian Federation
Moscow
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Review
For citations:
Lomakin N.V., Buryachkovskaya L.I., Sumarokov A.B., Gerasimov A.N., Gabbasov Z.A. Acute Coronary Syndrome Registry of High Risk Patients: 30-Day Outcome. Kardiologiia. 2019;59(11):14-20. (In Russ.) https://doi.org/10.18087/cardio.2019.11.n723
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