History of peripheral artery disease and cardiovascular risk of real-world patients with acute coronary syndrome: Role of inflammation and comorbidities.

Fiche du document

Auteurs
Date

1 juillet 2023

Type de document
Périmètre
Langue
Identifiants
Source

Serveur académique Lausannois

Relations

Ce document est lié à :
info:eu-repo/semantics/altIdentifier/doi/10.1016/j.ijcard.2023.03.043

Ce document est lié à :
info:eu-repo/semantics/altIdentifier/pmid/36958395

Ce document est lié à :
info:eu-repo/semantics/altIdentifier/eissn/1874-1754

Ce document est lié à :
info:eu-repo/semantics/altIdentifier/urn/urn:nbn:ch:serval-BIB_009B4EEC350F0

Collection

Serveur Académique Lausannois

Organisation

Université de Lausanne et CHUV

Licences

info:eu-repo/semantics/openAccess , CC BY 4.0 , https://creativecommons.org/licenses/by/4.0/

Mots-clés 0

Humans; Acute Coronary Syndrome/diagnosis; Acute Coronary Syndrome/epidemiology; Acute Coronary Syndrome/chemically induced; Cardiovascular Diseases/chemically induced; Platelet Aggregation Inhibitors/adverse effects; Prospective Studies; Risk Factors; Hemorrhage/diagnosis; Hemorrhage/epidemiology; Hemorrhage/chemically induced; Inflammation/diagnosis; Inflammation/epidemiology; Inflammation/chemically induced; Peripheral Arterial Disease/diagnosis; Peripheral Arterial Disease/epidemiology; Heart Disease Risk Factors; Acute coronary syndrome; Peripheral artery disease; Personalized therapy; Residual risk; Risk stratification

Sujets proches En

Inflammatory process

Citer ce document

A. Denegri et al., « History of peripheral artery disease and cardiovascular risk of real-world patients with acute coronary syndrome: Role of inflammation and comorbidities. », Serveur académique Lausannois, ID : 10.1016/j.ijcard.2023.03.043

Métriques

Partage / Export

Résumé 0

Patients with acute coronary syndromes (ACS) remain at risk of cardiovascular disease (CVD) recurrences. Peripheral artery disease (PAD) may identify a very high risk (VHR) group who may derive greater benefit from intensified secondary prevention. Among ACS-patients enrolled in the prospective multi-center Special Program University Medicine (SPUM), we assessed the impact of PAD on major cardiovascular events (MACE: composite of myocardial infarction, stroke and all-cause death) and major bleeding. Multivariate analysis tested the relation of each significant variable with MACE, as well as biomarkers of inflammation and novel markers of atherogenesis. Out of 4787 ACS patients, 6.0% (n = 285) had PAD. PAD-patients were older (p < 0.001), with established CVD and signs of increased persistent inflammation (hs-CRP; 23.6 ± 46.5 vs 10.4 ± 27.2 mg/l, p < 0.001 and sFlt-1; 1399.5 ± 1501.3 vs 1047.2 ± 1378.6 ng/l, p = 0.018). In-hospital-death (3.2% vs 1.4%, p = 0.022) and -MACE (5.6% vs 3.0%, p = 0.017) were higher in PAD-patients. MACE at 1 year (18.6% vs 7.9%,p < 0.001) remained increased even after adjustment for confounders (Adj. HR 1.53, 95% CI: 1.14-2.08, p = 0.005). Major bleeding did not differ between groups (Adj. HR 1.18; 95% CI 0.71-1.97, p = 0.512). Although PAD predicted MACE, PAD-patients were prescribed less frequently for secondary prevention at discharge. In this real-world ACS patient cohort, concomitant PAD is a marker of VHR and is associated with increased and persistent inflammation, higher risk for MACE without an increased risk of major bleeding. Therefore, a history of PAD may be useful to identify those ACS patients at VHR who require more aggressive secondary prevention.

document thumbnail

Par les mêmes auteurs

Sur les mêmes sujets

Exporter en