Incident Myocardial Infarction and Very Late Stent Thrombosis in Outpatients With Stable Coronary Artery Disease

Lemesle, Gilles; Tricot, Olivier; Meurice, Thibaud; Lallemant, Robert; Delomez, M; Equine, O; Lamblin, Nicolas; Bauters, Christophe

doi:10.1016/j.jacc.2017.02.050

Cited by 41 publications

(27 citation statements)

References 32 publications

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“…However, recent studies have shown that the annual mortality rate of SCAD is 0.63–3.8% . The CORONOR study showed that the annual incidence of myocardial infarction was 0.8% for patients with SCAD. Therefore, it is important to identify high‐risk patients with SCAD.…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of the GRACE discharge score for predicting the mortality of patients with stable coronary artery disease who underwent percutaneous coronary intervention

Zhao

Xian

et al. 2020

Cathet Cardio Intervent

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Objectives To assess the predictive value of the Global Registry of Acute Coronary Events (GRACE) discharge score for patients with stable coronary artery disease (SCAD) after percutaneous coronary intervention (PCI). Background The GRACE score is widely used for predicting the mortality of acute coronary syndrome patients. However, the predictive value of SCAD has not been sufficiently studied. Methods We studied 4,293 consecutive patients with SCAD who underwent PCI between January 2013 and December 2013. The primary endpoint was all‐cause mortality and the secondary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE). Results Among 3,915 patients with SCAD following PCI, there were 38 deaths and 394 MACCE during 2 years of follow‐up. The GRACE discharge score was significantly higher for patients who died than for those who survived (86.97 ± 23.27 vs. 71.07 ± 19.84; p < .001). Risk stratification of the GRACE score indicated that the mortality risk of the intermediate‐risk and high‐risk groups were 3.23‐fold (hazard ratio [HR], 3.23; range, 1.59–6.55; p = .001) and 15.31‐fold higher (HR, 15.31; range, 4.43–51.62; p < .001), respectively, than that of the low‐risk group. The MACCE risk for the intermediate‐risk and high‐risk groups were 1.28‐fold (HR, 1.28; range, 1.02–1.62; p = .037) and 2.42‐fold higher (HR, 2.42; range, 1.20–4.88; p = .014), respectively. The GRACE discharge score had prognostic value for mortality (area under the receiver operating characteristic curve, 0.692; p < .001). Conclusions The GRACE discharge score is valuable for the risk stratification of death and MACCE, as well as for the prognosis to mortality for SCAD patients who have undergone PCI.

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Section: Introductionmentioning

confidence: 99%

Prognostic value of the GRACE discharge score for predicting the mortality of patients with stable coronary artery disease who underwent percutaneous coronary intervention

Zhao

Xian

et al. 2020

Cathet Cardio Intervent

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“…These patients should be initiated on pathways to improve their lifestyles and especially on pathways that favor the cessation of cigarette smoking. In a systematic review of the scientific literature on lifestyle changes in patients with chronic ischemic heart disease, it has been found that the cessation of smoking, introduction of a healthier diet and engagement in physical activity may lead to a 36%, 44%, and 24% reduction in mortality, respectively . Recently, it has been found that in obese patients without metabolic alterations, the incidence of coronary heart disease is 49% higher than in non‐obese patients .…”

Section: Discussionmentioning

confidence: 99%

Stable atypical chest pain with negative anatomical or functional diagnostic test: Diagnosis no matter what or prevention at any cost?

Cosmi¹,

Mariottoni

Cosmi

2019

Clinical Cardiology

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Background Approximately 1% to 2% of patients with stable atypical chest pain (SACP) experienced a major coronary event, even after a negative functional or anatomical test. Methods Over the past 15 years, 1706 patients with SACP evaluated in our clinics underwent functional stress testing or coronary computed tomographic angiography (CTA). In these patients, we also assessed the presence of three major modifiable lifestyle‐related risk factors (cigarette smoking, low intake of fruit and vegetables, and physical inactivity). Patients were stratified according to the presence of at least one risky lifestyle factor or no risky lifestyle factors. Functional or anatomical tests were positive in 170 patients (10%). We followed the remaining 1536 patients with negative tests for 1 year to evaluate the incidence of major coronary events. Results The percentage of patients reporting major coronary events was 1.2% in the group with risky lifestyles and 0.2% in the non‐risky lifestyle group (P < .01). Events were more common in smokers. Conclusions Patients with SACP, when functional or anatomical tests are negative, have a residual risk of fatal and non‐fatal cardiovascular events of 1% at 1 year of follow‐up. People with incorrect lifestyles, especially smokers, have a higher risk of events. We think that in this population, a more effective intervention on lifestyles could be the key to reduce major cardiovascular events.

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“…Specifically, patients with cardiovascular disease may incorrectly self‐report smoking status since they are under the pressure to quit smoking 38. For CABG, several trials have shown its survival benefits compared with percutaneous revascularization or medical treatments in patients with severe coronary heart disease 39, 40, 41. Thus, the prognostic value of CABG may depend on patient characteristics.…”

Section: Discussionmentioning

confidence: 99%

International Validation of the Thrombolysis in Myocardial Infarction (TIMI) Risk Score for Secondary Prevention in Post‐MI Patients: A Collaborative Analysis of the Chronic Kidney Disease Prognosis Consortium and the Risk Validation Scientific Committee

Mok

Ballew

Bash

et al. 2018

JAHA

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BackgroundThe Thrombolysis in Myocardial Infarction (TIMI) Risk Score for Secondary Prevention (TRS2°P), a 0‐to‐9‐point system based on the presence/absence of 9 clinical factors, was developed to classify the risk of major adverse cardiovascular events (MACE) (a composite of cardiovascular death, recurrent myocardial infarction, or ischemic stroke) among patients with a recent myocardial infarction. Its performance has not been examined internationally outside of a clinical trial setting.Methods and ResultsWe evaluated the performance of TRS2°P for predicting MACE in 53 599 patients with recent myocardial infarction in 5 international cohorts from New Zealand, South Korea, Sweden, and the United States participating in the Chronic Kidney Disease Prognosis Consortium. Overall, there were 19 444 cases of MACE across 5 cohorts over a mean follow‐up of 5 years, and the overall MACE rate ranged from 5.0 to 18.4 (per 100 person‐years). The TRS2°P showed modest calibration (Brier score ranged from 0.144 to 0.173) and discrimination (C‐statistics >0.61 in all studies except 1 from Korea with 0.55) across cohorts relative to its original Brier score of 0.098 and C‐statistic of 0.67 in the derived data set. Although there was some heterogeneity across cohorts, the 9 predictors in the TRS2°P were generally associated with higher MACE risk, with strongest associations observed (meta‐analyzed adjusted hazard ratio 1.6–1.7) for history of heart failure, age ≥75 years, and prior stroke, followed by peripheral artery disease, kidney dysfunction, diabetes mellitus, and hypertension (hazard ratio 1.3–1.4). Prior coronary bypass graft surgery and smoking did not reach statistical significance (hazard ratio ≈1.1).ConclusionsTRS2°P, a simple scoring system with 9 routine clinical factors, was modestly predictive of secondary events when applied in patients with recent myocardial infarction from diverse clinical and geographic settings.

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Incident Myocardial Infarction and Very Late Stent Thrombosis in Outpatients With Stable Coronary Artery Disease

Abstract: In stable CAD outpatients, incident MI occurs at a stable rate of 0.8% annually, is related to VLST in one-fifth of cases, and is associated with an increased mortality risk, especially for VLST. Multivessel CAD and residual uncontrolled risk factors are strongly associated with MI.

Cited by 41 publications

References 32 publications

Prognostic value of the GRACE discharge score for predicting the mortality of patients with stable coronary artery disease who underwent percutaneous coronary intervention

Prognostic value of the GRACE discharge score for predicting the mortality of patients with stable coronary artery disease who underwent percutaneous coronary intervention

Stable atypical chest pain with negative anatomical or functional diagnostic test: Diagnosis no matter what or prevention at any cost?

International Validation of the Thrombolysis in Myocardial Infarction (TIMI) Risk Score for Secondary Prevention in Post‐MI Patients: A Collaborative Analysis of the Chronic Kidney Disease Prognosis Consortium and the Risk Validation Scientific Committee

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