Background The left atrial size has been considered as a useful marker of adverse cardiovascular outcomes. However, it is not well known whether left atrial area index （LAAI） has predictive value for prognosis in pa...Background The left atrial size has been considered as a useful marker of adverse cardiovascular outcomes. However, it is not well known whether left atrial area index （LAAI） has predictive value for prognosis in patients with unstable angina pectoris （UAP）. This study was aimed to assess the association between LAAI and outcomes in UAP patients. Methods We enrolled a total of 391 in-hospital patients diag- nosed as UAP. Clinical and echocardiographic data at baseline were collected. The patients were followed for the development of ad- verse cardiovascular （CV） events, including hospital readmission for angina pectoris, acute myocardial infarction （AMI）, congestive heart failure （CHF）, stroke and all-cause mortality. Results During a mean follow-up time of 26.3±8.6 months, 98 adverse CV events occurred （84 hospital readmission for angina pectoris, four AMI, four CHF, one stroke and five all-cause mortality）. In a multivariate Cox model, LAAI [OR： 1.140, 95% CI： 1.01±1.279, P = 0.026], diastolic blood pressure （OR： 0.976, 95% CI： 0.956-0.996, P = 0.020） and pulse pressure （OR 1.020, 95% CI： 1.007-1.034, P = 0.004） were independent predictors for adverse CV events in UAP patients. Conclusions LAAI is a predictor of adverse CV events independent of clinical and other echocardiographic parameters in UAP patients.展开更多
Background This prospective study integrated multiple clinical indexes and inflammatory markers associated with coronary atherosclerotic vulnerable plaque to establish a risk prediction model that can evaluate a patie...Background This prospective study integrated multiple clinical indexes and inflammatory markers associated with coronary atherosclerotic vulnerable plaque to establish a risk prediction model that can evaluate a patient with certain risk factors for the likelihood of the occurrence of a coronary heart disease event within one year. Methods This study enrolled in 2686 patients with mild to moderate coronary artery lesions. Eighty-five indexes were recorded, included baseline clinical data, laboratory studies, and procedural characteristics. During the 1-year follow-up, 233 events occurred, five patients died, four patients suffered a nonfatal myocardial infarction, four patients underwent revascularization, and 220 patients were readmitted for angina pectoris. The Risk Estimation Model and the Simplified Model were conducted using Bayesian networks and compared with the Single Factor Models. Results The area under the curve was 0.88 for the Bayesian Model and 0.85 for the Simplified Model, while the Single Factor Model had a maximum area under the curve of 0.65. Conclusion The new models can be used to assess the short-term risk of individual coronary heart disease events and may assist in guiding preventive care.展开更多
Background There are limited data on the prevalence of electrocardiographic (ECG) abnormalities, and their value for predicting a major adverse cardiovascular event (MACE) in patients at high cardiovascular risk. This...Background There are limited data on the prevalence of electrocardiographic (ECG) abnormalities, and their value for predicting a major adverse cardiovascular event (MACE) in patients at high cardiovascular risk. This study aimed to determine the prevalence of ECG abnormalities in patients at high risk for cardiovascular events, and to identify ECG abnormalities that significantly predict MACE. Methods Patients aged ≥ 45 years with established atherosclerotic disease (EAD) were consecutively enrolled from the outpatient clinics of the six participating hospitals during April 2011 to March 2014. The following data were collected: demographic data, cardiovascular risk factors, history of cardiovascular event, physical examination, ECG and medications. ECG was analyzed using Minnesota Code criteria. MACE included cardiovascular death, non-fatal myocardial infarction, and hospitalization due to unstable angina or heart failure. Results A total of 2009 patients were included, 1048 patients (52.2%) had established EAD, and 961 patients (47.8%) had multiple risk factors (MRF). ECG abnormalities included atrial fibrillation (6.7%), premature ventricular contraction (5.4%), pathological Q-wave (Q/QS)(21.3%), T-wave inversion (20.0%), intraventricular ventricular conduction delay (IVCD)(7.3%), left ventricular hypertrophy (LVH)(12.2%), and AV block (12.5%). MACE occurred in 88 patients (4.4%). Independent predictors of MACE were chronic kidney disease, EAD, and the presence of atrial fibrillation, Q/QS, IVCD or LVH by ECG. Conclusions A high prevalence of ECG abnormalities was found. The prevalence of ECG abnormalities was high even among those with risk factors without documented cardiovascular disease.展开更多
We have read the article which entitled ＂Neutrophil-to- lymphocyte ratio compared to N-terminal pro-brain natri- uretic peptide as a prognostic marker of adverse events in elderly patients with chronic heart failure...We have read the article which entitled ＂Neutrophil-to- lymphocyte ratio compared to N-terminal pro-brain natri- uretic peptide as a prognostic marker of adverse events in elderly patients with chronic heart failure＂ published in Journal of Geriatric Cardiology with great interest, However, we have some comments regarding this study.展开更多
Background Hypercholesterolemia is a major risk factor for cardiovascular events in patients with established atherosclerotic disease (EAD) and in those with multiple risk factors (MRFs). This study aimed to investiga...Background Hypercholesterolemia is a major risk factor for cardiovascular events in patients with established atherosclerotic disease (EAD) and in those with multiple risk factors (MRFs). This study aimed to investigate the rate of optimal low-density lipoprotein (LDL) cholesterol level in a multicenter registry of patients at high risk for cardiovascular events. Methods A multicenter registry of EAD and MRF patients was conducted. Demographic data,medical history,cardiovascular risk factors,anthropometric data,laboratory data,and medications were recorded and analyzed. We classified patients according to target LDL levels based on recommendation by the European Society of Cardiology (ESC) 2011 into Group 1 which is EAD and diabetes or chronic kidney disease (CKD)–target LDL below 70 mg/dL,and Group 2 which is MRF without diabetes or CKD–target LDL below 100 mg/dL. The rate of optimal LDL level in patients with Group 1 and Group 2 was analyzed and stratified according to the treatment pattern of lipid-lowering medications. Results A total of 3100 patients were included. Of those,51.7% were male. Average age was 65.8 ± 9.7 years. Average LDL level was 96.3 ± 32.6 mg/dL. A vast majority (92.7%) received statin and 9.3% received ezetimibe. Optimal LDL level was achieved in 20.3% of patients in Group 1 (LDL < 70 mg/dL),and in 46.6% in Group 2 (LDL < 100 mg/dL). The overall rate of optimal LDL control was 23% since 89.6% of study population belongs to Group 1. The rate of optimal LDL was not different between high and low potency statin. Factors that were associated with optimal LDL control were older age,the presence of coronary artery disease or peripheral artery disease. Conclusions The rates of optimal LDL level were unacceptably low in this study population. As such,a strategy to improve LDL control in high-risk population should be implemented.展开更多
文摘Background The left atrial size has been considered as a useful marker of adverse cardiovascular outcomes. However, it is not well known whether left atrial area index （LAAI） has predictive value for prognosis in patients with unstable angina pectoris （UAP）. This study was aimed to assess the association between LAAI and outcomes in UAP patients. Methods We enrolled a total of 391 in-hospital patients diag- nosed as UAP. Clinical and echocardiographic data at baseline were collected. The patients were followed for the development of ad- verse cardiovascular （CV） events, including hospital readmission for angina pectoris, acute myocardial infarction （AMI）, congestive heart failure （CHF）, stroke and all-cause mortality. Results During a mean follow-up time of 26.3±8.6 months, 98 adverse CV events occurred （84 hospital readmission for angina pectoris, four AMI, four CHF, one stroke and five all-cause mortality）. In a multivariate Cox model, LAAI [OR： 1.140, 95% CI： 1.01±1.279, P = 0.026], diastolic blood pressure （OR： 0.976, 95% CI： 0.956-0.996, P = 0.020） and pulse pressure （OR 1.020, 95% CI： 1.007-1.034, P = 0.004） were independent predictors for adverse CV events in UAP patients. Conclusions LAAI is a predictor of adverse CV events independent of clinical and other echocardiographic parameters in UAP patients.
文摘Background This prospective study integrated multiple clinical indexes and inflammatory markers associated with coronary atherosclerotic vulnerable plaque to establish a risk prediction model that can evaluate a patient with certain risk factors for the likelihood of the occurrence of a coronary heart disease event within one year. Methods This study enrolled in 2686 patients with mild to moderate coronary artery lesions. Eighty-five indexes were recorded, included baseline clinical data, laboratory studies, and procedural characteristics. During the 1-year follow-up, 233 events occurred, five patients died, four patients suffered a nonfatal myocardial infarction, four patients underwent revascularization, and 220 patients were readmitted for angina pectoris. The Risk Estimation Model and the Simplified Model were conducted using Bayesian networks and compared with the Single Factor Models. Results The area under the curve was 0.88 for the Bayesian Model and 0.85 for the Simplified Model, while the Single Factor Model had a maximum area under the curve of 0.65. Conclusion The new models can be used to assess the short-term risk of individual coronary heart disease events and may assist in guiding preventive care.
基金supported by the Heart Association of Thailand under the Royal Patronage of H.M. the King, National Research Council of Thailand
文摘Background There are limited data on the prevalence of electrocardiographic (ECG) abnormalities, and their value for predicting a major adverse cardiovascular event (MACE) in patients at high cardiovascular risk. This study aimed to determine the prevalence of ECG abnormalities in patients at high risk for cardiovascular events, and to identify ECG abnormalities that significantly predict MACE. Methods Patients aged ≥ 45 years with established atherosclerotic disease (EAD) were consecutively enrolled from the outpatient clinics of the six participating hospitals during April 2011 to March 2014. The following data were collected: demographic data, cardiovascular risk factors, history of cardiovascular event, physical examination, ECG and medications. ECG was analyzed using Minnesota Code criteria. MACE included cardiovascular death, non-fatal myocardial infarction, and hospitalization due to unstable angina or heart failure. Results A total of 2009 patients were included, 1048 patients (52.2%) had established EAD, and 961 patients (47.8%) had multiple risk factors (MRF). ECG abnormalities included atrial fibrillation (6.7%), premature ventricular contraction (5.4%), pathological Q-wave (Q/QS)(21.3%), T-wave inversion (20.0%), intraventricular ventricular conduction delay (IVCD)(7.3%), left ventricular hypertrophy (LVH)(12.2%), and AV block (12.5%). MACE occurred in 88 patients (4.4%). Independent predictors of MACE were chronic kidney disease, EAD, and the presence of atrial fibrillation, Q/QS, IVCD or LVH by ECG. Conclusions A high prevalence of ECG abnormalities was found. The prevalence of ECG abnormalities was high even among those with risk factors without documented cardiovascular disease.
文摘We have read the article which entitled ＂Neutrophil-to- lymphocyte ratio compared to N-terminal pro-brain natri- uretic peptide as a prognostic marker of adverse events in elderly patients with chronic heart failure＂ published in Journal of Geriatric Cardiology with great interest, However, we have some comments regarding this study.
基金supported by the Heart Association of Thailand under the Royal Patronage of H.M. the Kingthe National Research Council of Thailand
文摘Background Hypercholesterolemia is a major risk factor for cardiovascular events in patients with established atherosclerotic disease (EAD) and in those with multiple risk factors (MRFs). This study aimed to investigate the rate of optimal low-density lipoprotein (LDL) cholesterol level in a multicenter registry of patients at high risk for cardiovascular events. Methods A multicenter registry of EAD and MRF patients was conducted. Demographic data,medical history,cardiovascular risk factors,anthropometric data,laboratory data,and medications were recorded and analyzed. We classified patients according to target LDL levels based on recommendation by the European Society of Cardiology (ESC) 2011 into Group 1 which is EAD and diabetes or chronic kidney disease (CKD)–target LDL below 70 mg/dL,and Group 2 which is MRF without diabetes or CKD–target LDL below 100 mg/dL. The rate of optimal LDL level in patients with Group 1 and Group 2 was analyzed and stratified according to the treatment pattern of lipid-lowering medications. Results A total of 3100 patients were included. Of those,51.7% were male. Average age was 65.8 ± 9.7 years. Average LDL level was 96.3 ± 32.6 mg/dL. A vast majority (92.7%) received statin and 9.3% received ezetimibe. Optimal LDL level was achieved in 20.3% of patients in Group 1 (LDL < 70 mg/dL),and in 46.6% in Group 2 (LDL < 100 mg/dL). The overall rate of optimal LDL control was 23% since 89.6% of study population belongs to Group 1. The rate of optimal LDL was not different between high and low potency statin. Factors that were associated with optimal LDL control were older age,the presence of coronary artery disease or peripheral artery disease. Conclusions The rates of optimal LDL level were unacceptably low in this study population. As such,a strategy to improve LDL control in high-risk population should be implemented.
