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PREDICTORS OF ISCHEMIC EVENTS WITHIN AND AFTER 1 YEAR AFTER AN ACUTE CORONARY SYNDROME: RESULTS FROM THE EPICOR REGISTRY
230 JACC March 21, 2017 Volume 69, Issue 11
Acute and Stable Ischemic Heart Disease PREDICTORS OF ISCHEMIC EVENTS WITHIN AND AFTER 1 YEAR AFTER AN ACUTE CORONARY SYNDROME: RESULTS FROM THE EPICOR REGISTRY Poster Contributions Poster Hall, Hall C Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m. Session Title: Acute Coronary Syndromes, Diagnosis, Management and Outcomes Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical Presentation Number: 1253-330 Authors: Uwe Zeymer, Xavier Rossello, Stuart J. Pocock, Frans Van de Werf, Nicolas Danchin, Lieven Annemans, Jesús Medina, Héctor Bueno, Klinikum Ludwigshafen and Institut für Herzinfarktforschung Ludwigshafen, Ludwigshafen, Germany
Background: Patients discharged after an acute coronary syndrome (ACS) have substantial risk of recurrent ischemic events (MACCE = death, MI, stroke).
Methods: EPICOR (NCT01171404) is a prospective, international, real-world cohort study of consecutive patients hospitalized for an ACS within 24 hours of symptom onset, who survived to discharge. 10,567 patients enrolled from 555 hospitals in 20 countries in Europe and Latin America were followed for 2 years. 4,943 were admitted with ST-segment elevation (STE) MI and 5,624 with non-STE-ACS. We studied potential baseline predictors of MACCE in the first and second year post-discharge using multivariable Cox proportional hazard models. Results: The rates per 100 person-years at risk within and after the first year are:
MACCE Death Non-Fatal (NF) MI NF-stroke
First year Incidence 5.27 4.11 1.01 0.14
95% CI 4.83-5.75 3.73-4.54 0.83-1.24 0.09-0.24
Second year Incidence 3.61 2.32 1.14 0.14
95% CI 3.22-4.04 2.02-2.67 0.93-1.39 0.08-0.25
Older age, lack of coronary revascularization, creatinine, hemoglobin, previous cardiac disease, previous chronic obstructive pulmonary disease, glucose, male gender and region were risk factors for MACCE during the 1st- and 2nd-follow up year but ejection fraction, quality of life, low body mass index <20 kg/m2, in-hospital cardiac complications and Killip class lost predictive power after the first year. Conclusions: In our cohort mortality is higher in the first year after ACS, while rates of MI and stroke did not change. Some predictors of early ischemic events after an ACS lose their predictive power over time.
Acute and Stable Ischemic Heart Disease PREDICTORS OF ISCHEMIC EVENTS WITHIN AND AFTER 1 YEAR AFTER AN ACUTE CORONARY SYNDROME: RESULTS FROM THE EPICOR REGISTRY Poster Contributions Poster Hall, Hall C Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m. Session Title: Acute Coronary Syndromes, Diagnosis, Management and Outcomes Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical Presentation Number: 1253-330 Authors: Uwe Zeymer, Xavier Rossello, Stuart J. Pocock, Frans Van de Werf, Nicolas Danchin, Lieven Annemans, Jesús Medina, Héctor Bueno, Klinikum Ludwigshafen and Institut für Herzinfarktforschung Ludwigshafen, Ludwigshafen, Germany
Background: Patients discharged after an acute coronary syndrome (ACS) have substantial risk of recurrent ischemic events (MACCE = death, MI, stroke).
Methods: EPICOR (NCT01171404) is a prospective, international, real-world cohort study of consecutive patients hospitalized for an ACS within 24 hours of symptom onset, who survived to discharge. 10,567 patients enrolled from 555 hospitals in 20 countries in Europe and Latin America were followed for 2 years. 4,943 were admitted with ST-segment elevation (STE) MI and 5,624 with non-STE-ACS. We studied potential baseline predictors of MACCE in the first and second year post-discharge using multivariable Cox proportional hazard models. Results: The rates per 100 person-years at risk within and after the first year are:
MACCE Death Non-Fatal (NF) MI NF-stroke
First year Incidence 5.27 4.11 1.01 0.14
95% CI 4.83-5.75 3.73-4.54 0.83-1.24 0.09-0.24
Second year Incidence 3.61 2.32 1.14 0.14
95% CI 3.22-4.04 2.02-2.67 0.93-1.39 0.08-0.25
Older age, lack of coronary revascularization, creatinine, hemoglobin, previous cardiac disease, previous chronic obstructive pulmonary disease, glucose, male gender and region were risk factors for MACCE during the 1st- and 2nd-follow up year but ejection fraction, quality of life, low body mass index <20 kg/m2, in-hospital cardiac complications and Killip class lost predictive power after the first year. Conclusions: In our cohort mortality is higher in the first year after ACS, while rates of MI and stroke did not change. Some predictors of early ischemic events after an ACS lose their predictive power over time.