American College of Cardiology key data elements and definitions for measuring the clinical management and outcomes of patients with acute coronary syndromes31This document was approved by the American College of Cardiology Board of Trustees in November 2001.32When citing this document, the American College of Cardiology would appreciate the following citation format: Cannon CP, Battler A, Brindis RG, Cox JL, Ellis SG, Every NR, Flaherty JT, Harrington RA, Krumholz HM, Simoons ML, Van de Werf FJJ, Weintrau

Cannon, Christopher P.; Battler, Alexander; Brindis, Ralph G.; Cox, Jafna L.; Ellis, Stephen G.; Every, Nathan R.; Flaherty, John T.; Harrington, Robert A.; Krumholz, Harlan M.; Simoons, Maarten L.; Werf, Frans J.J. Van de; Weintraub, William S.; Mitchell, Kristi; Morrisson, Susan L; Anderson, H. Vernon; Cannom, David S.; Chitwood, W. Randolph; Cigarroa, Joaquin E.; Collins-Nakai, Ruth L.; Gibbons, Raymond J.; Grover, Frederick L.; Heidenreich, Paul A.; Khandheria, Bijoy K.; Knoebel, Suzanne B.; Krumholz, Harlan; Malenka, David J.; Mark, Daniel B.; McKay, Charles R.; Passamani, Eugene R.; Radford, Martha J.; Riner, Ronald N.; Schwartz, Janice B.; Shaw, Richard E.; Shemin, Richard J.; Fossen, Douglas B. Van; Verrier, Edward D.; Watkins, Matthew W.; Phoubandith, Dawn R.; Furnelli, Tori

doi:10.1016/s0735-1097(01)01702-8

Cited by 596 publications

(122 citation statements)

References 36 publications

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“…Disability from stroke was classified as none to minor if the patient is left with no or mild disability and is completely self-dependent and functional, severe if the patient has severe limitation of functional ability, or is bedridden or in a wheel chair and needs considerable help or is fully dependent on others for self-care and daily activities at home or work. If the patient died from complications of stroke, the case was classified as death [41]. Early statin use was defined as statin administration during the first 24 h of hospitalization.…”

Section: Methodsmentioning

confidence: 99%

Early Stroke following Acute Myocardial Infarction: Incidence, Predictors and Outcome in Six Middle-Eastern Countries

Albaker

Zubaid²,

Alsheikh‐Ali³

et al. 2011

Cerebrovasc Dis

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Background and Objectives: Stroke is a potential complication of acute myocardial infarction (AMI). The aim of this study was to identify the incidence, risk factors predisposing to stroke and in-hospital outcome during the index admission with AMI among patients in the Middle East. Methods: For a period of 6 months in 2006 and 2007, 5,833 consecutive AMI patients were enrolled from 64 hospitals in 6 Middle East countries. Results: The incidence of in-hospital stroke following AMI was 0.85%. Most cases were ST segment elevation AMI-related and ischemic in nature. Patients with in-hospital stroke were older than patients without stroke and were more likely to be female (36 vs. 18.6%, p = 0.0033). They were also more likely to have diabetes mellitus, dyslipidemia, prior AMI, or percutaneous/surgical coronary revascularization. Patients with stroke were more likely to present with advanced Killip class II–IV, higher mean heart rate and higher serum creatinine. Independent predictors of stroke were age, prior stroke, prior coronary artery bypass surgery, anterior AMI and systolic blood pressure >190 mm Hg on presentation. Early administration of statins was independently associated with reduced stroke risk (odds ratio, OR, 0.4, 95% confidence interval, CI, 0.19–0.90, p = 0.025). Stroke was fatal in 44% of the cases and was independently associated with in-hospital mortality (adjusted OR 12.5, 95% CI 5.7–27.4, p < 0.01). Conclusion: There is a low incidence of in-hospital stroke in Middle-Eastern patients presenting with AMI but with very high fatality rates. Early statin therapy was associated with a significant reduction in stroke risk. Future work should be focused on reducing the risk and improving the outcome of this devastating complication.

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Section: Methodsmentioning

confidence: 99%

Early Stroke following Acute Myocardial Infarction: Incidence, Predictors and Outcome in Six Middle-Eastern Countries

Albaker

Zubaid²,

Alsheikh‐Ali³

et al. 2011

Cerebrovasc Dis

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“…The use of certain medications was recorded upon patient discharge. The diagnosis of an AMI was based on an increase either in the level of creatinine kinase-MB isoenzyme (CK-MB) or in the level of troponin I or T higher than the upper limit of normal and either symptoms consistent with acute myocardial ischemia or ECG changes in at least two contiguous leads (pathologic Q waves, persistent ST-segment elevation, or ST-segment depression >0.1 mV) [11]. The study population was categorized into four groups on the basis of the combined status of CKD and AF.…”

Section: Methodsmentioning

confidence: 99%

Clinical Significance of Chronic Kidney Disease and Atrial Fibrillation on Morbidity and Mortality in Patients with Acute Myocardial Infarction

Hwang¹,

Park

Yoon³

et al. 2014

Am J Nephrol

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Background/Aims: Atrial fibrillation (AF) often coexists with acute myocardial infarction (AMI), and chronic kidney disease (CKD) is a major risk for AMI. However, the combined impact of CKD and AF on the mortality and morbidity in AMI population has not been determined. Methods: Between January 2004 and December 2009, a total of 4,738 AMI patients were enrolled prospectively. Patients were divided into four groups according to the combined status of CKD and AF. The primary endpoint was a combination of 5-year major adverse cardiac and cerebrovascular events (MACCE). Results: The prevalence of AF was significantly higher in CKD patients than in non-CKD patients (6.76 vs. 3.31%, p < 0.001). The highest cumulative event rate of MACCE and death was observed in patients with both CKD and AF (68.5 and 64.0%), respectively. In multivariable analyses, compared with patients with neither AF nor CKD, hazard ratios (HR) for composite of MACCE were 1.66 (95% CI, 1.14-2.41), 1.24 (95% CI, 1.06-1.46), and 2.10 (95% CI, 1.42-3.13) for patients with AF only, those with CKD only, and those with both CKD and AF, respectively (p for interaction = 0.935). Patients with both CKD and AF had a greatest risk for all-cause mortality (HR 2.54; 95% CI, 1.60-4.53), and the significant synergistic interaction was observed between CKD and AF (p for interaction = 0.015). Conclusion: The combined effect of AF and CKD on the risk of MACCE after an AMI is stronger than any separate condition, and it confers a synergistic effect on the all-cause mortality risk.

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“…Modifiable risk factors were documented in the patient’s medical history: dyslipidemia (defined as a history of dyslipidemia if diagnosed and/or treated by a physician), arterial hypertension (defined as a history of arterial hypertension diagnosed and/or treated by a physician and/or documented blood pressure >140/90 mm Hg) and diabetes (defined as a history of diabetes, regardless of duration of disease if the patient had been treated for diabetes and was previously diagnosed by a physician) [15]. Documentation of the modifiable risk factors provided by the local physicians was accepted as stated.…”

Section: Methodsmentioning

confidence: 99%

Characteristics and Outcome in Acute Coronary Syndrome Patients with and without Established Modifiable Cardiovascular Risk Factors: Insights from the Nationwide AMIS Plus Registry 1997–2010

et al. 2012

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Objectives: Little is known about patients without known modifiable risk factors presenting initially with acute coronary syndrome (ACS). This study assessed baseline characteristics and outcomes of ACS patients with and without the known modifiable risk factors arterial hypertension, dyslipidemia, obesity, smoking or diabetes. Methods: All ACS patients enrolled in the AMIS Plus Registry between 1997 and 2010 were analyzed until hospital discharge; a subgroup was re-assessed at the 1-year follow-up. Outcome measures were in-hospital mortality and major adverse cardiac or cerebrovascular events (MACCE) defined as a composite outcome of mortality, re-infarction and cerebrovascular events. Results: Of 33,306 patients, 2,125 (6.4%) had none of these modifiable risk factors. They were older (males), had less moderate or severe comorbidities and were more frequently in Killip class I on admission. Treatment of ACS patients with or without modifiable risk factors was similar with regard to interventional therapies and use of antiplatelet agents. In-hospital mortality was lower in patients without modifiable risk factors but in-hospital MACCE and 1-year survival was similar. Conclusion: Lack of modifiable risk factors was an independent predictor of lower in-hospital mortality but not of MACCE in patients who presented with ACS.

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Cited by 596 publications

References 36 publications

Early Stroke following Acute Myocardial Infarction: Incidence, Predictors and Outcome in Six Middle-Eastern Countries

Early Stroke following Acute Myocardial Infarction: Incidence, Predictors and Outcome in Six Middle-Eastern Countries

Clinical Significance of Chronic Kidney Disease and Atrial Fibrillation on Morbidity and Mortality in Patients with Acute Myocardial Infarction

Characteristics and Outcome in Acute Coronary Syndrome Patients with and without Established Modifiable Cardiovascular Risk Factors: Insights from the Nationwide AMIS Plus Registry 1997–2010

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