دورية أكاديمية
أعرض في EDS

Non-invasive vascular measures as prognostic predictors for older patients with non-ST elevation acute coronary syndrome.

التفاصيل البيبلوغرافية
العنوان: Non-invasive vascular measures as prognostic predictors for older patients with non-ST elevation acute coronary syndrome.
المؤلفون: Dirjayanto VJ; Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.; Faculty of Medicine, Universitas Indonesia, Indonesia, Jakarta., Pompei G; Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.; Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona, FE., Rubino F; Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.; Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy., Biscaglia S; Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona, FE., Campo G; Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona, FE., Mihailidou AS; Department of Cardiology and Kolling Institute, Royal North Shore Hospital and Macquarie University, Sydney, New South Wales, Australia., den Ruijter H; Division Heart and Lungs, Laboratory of Experimental Cardiology, University Medical Center Utrecht, Amsterdam., Kunadian V; Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.; Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
المصدر: Coronary artery disease [Coron Artery Dis] 2024 Aug 01; Vol. 35 (5), pp. 368-381. Date of Electronic Publication: 2024 Mar 04.
نوع المنشور: Journal Article; Multicenter Study
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: England NLM ID: 9011445 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1473-5830 (Electronic) Linking ISSN: 09546928 NLM ISO Abbreviation: Coron Artery Dis Subsets: MEDLINE
أسماء مطبوعة: Publication: London : Lippincott Williams & Wilkins
Original Publication: Philadelphia, Pa. : Current Science, c1990-
مواضيع طبية MeSH: Acute Coronary Syndrome*/physiopathology , Acute Coronary Syndrome*/mortality , Acute Coronary Syndrome*/diagnosis , Acute Coronary Syndrome*/therapy , Carotid Intima-Media Thickness* , Vascular Stiffness*/physiology, Humans ; Female ; Male ; Aged ; Prognosis ; Aged, 80 and over ; Endothelium, Vascular/physiopathology ; Risk Factors ; Predictive Value of Tests ; Carotid-Femoral Pulse Wave Velocity/methods ; Risk Assessment/methods
مستخلص: Background: Adverse cardiac events are common in older patients with non-ST elevation acute coronary syndrome (NSTEACS), yet prognostic predictors are still lacking. This study investigated the long-term prognostic significance of non-invasive measures including endothelial function, carotid intima-media thickness (CIMT), and vascular stiffness in older NSTEACS patients referred for invasive treatment.
Methods: NSTEACS patients aged 75 years and older recruited to a multicentre cohort study (NCT01933581) were assessed for baseline endothelial function using endoPAT logarithm of reactive hyperemia index (LnRHI), CIMT using B-mode ultrasound, and vascular stiffness using carotid-femoral pulse wave velocity (cfPWV). Long-term outcomes included major adverse cardiovascular events (MACE), a composite of death, reinfarction, urgent revascularization, stroke/transient ischemic attack, and significant bleeding.
Results: Recruitment resulted in 214 patients assessed for LnRHI, 190 patients assessed for CIMT and 245 patients assessed for cfPWV. For LnRHI group (median follow-up 4.73 years [IQR: 1.41-5.00]), Cox regression analysis revealed a trend towards increased risk of MACE (HR: 1.24 [95% CI: 0.80-1.93]; P  = 0.328) and mortality (HR: 1.49 [95% CI: 0.86-2.59]; P  = 0.157), but no significance was reached. No difference for other components of MACE was found. For CIMT group (median follow up 4.74 years [IQR: 1.55-5.00]), no statistically significant difference in MACE was found (HR: 0.92 [95% CI: 0.53-1.59]; P  = 0.754). Similarly, for cfPWV group (median follow-up 4.96 years [IQR: 1.55-5.00]), results did not support prognostic significance (for MACE, HR: 0.95 [95% CI: 0.65-1.39]; P  = 0.794).
Conclusion: Endothelial function, CIMT and vascular stiffness were proven unsuitable as strong prognostic predictors in older patients with NSTEACS.
Clinical Trial Registration: NCT01933581.
(Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
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سلسلة جزيئية: ClinicalTrials.gov NCT01933581
تواريخ الأحداث: Date Created: 20240304 Date Completed: 20240625 Latest Revision: 20240701
رمز التحديث: 20240701
DOI: 10.1097/MCA.0000000000001352
PMID: 38436050
قاعدة البيانات: MEDLINE
الوصف
تدمد:1473-5830
DOI:10.1097/MCA.0000000000001352