Risk factors for major adverse cardiovascular events after the first acute coronary syndrome
Okkonen, Marjo; Havulinna, Aki S.; Ukkola, Olavi; Huikuri, Heikki; Pietilä, Arto; Koukkunen, Heli; Lehto, Seppo; Mustonen, Juha; Ketonen, Matti; Airaksinen, Juhani; Kesäniemi, Y. Antero; Salomaa, Veikko (2021-06-03)
Marjo Okkonen, Aki S. Havulinna, Olavi Ukkola, Heikki Huikuri, Arto Pietilä, Heli Koukkunen, Seppo Lehto, Juha Mustonen, Matti Ketonen, Juhani Airaksinen, Y. Antero Kesäniemi & Veikko Salomaa (2021) Risk factors for major adverse cardiovascular events after the first acute coronary syndrome, Annals of Medicine, 53:1, 817-823, DOI: 10.1080/07853890.2021.1924395
© 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group This is an Open Access article distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
https://creativecommons.org/licenses/by/4.0/
https://urn.fi/URN:NBN:fi-fe2021090345148
Tiivistelmä
Abstract
Aims: To evaluate risk factors for major adverse cardiac event (MACE) after the first acute coronary syndrome (ACS) and to examine the prevalence of risk factors in post-ACS patients.
Methods: We used Finnish population-based myocardial infarction register, FINAMI, data from years 1993–2011 to identify survivors of first ACS (n = 12686), who were then followed up for recurrent events and all-cause mortality for three years. Finnish FINRISK risk factor surveys were used to determine the prevalence of risk factors (smoking, hyperlipidaemia, diabetes and blood pressure) in post-ACS patients (n = 199).
Results: Of the first ACS survivors, 48.4% had MACE within three years of their primary event, 17.0% were fatal. Diabetes (p = 4.4 × 10−7), heart failure (HF) during the first ACS attack hospitalization (p = 6.8 × 10−15), higher Charlson index (p = 1.56 × 10−19) and older age (p = .026) were associated with elevated risk for MACE in the three-year follow-up, and revascularization (p = .0036) was associated with reduced risk. Risk factor analyses showed that 23% of ACS survivors continued smoking and cholesterol levels were still high (>5mmol/l) in 24% although 86% of the patients were taking lipid lowering medication.
Conclusion: Diabetes, higher Charlson index and HF are the most important risk factors of MACE after the first ACS. Cardiovascular risk factor levels were still high among survivors of first ACS.
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