Predictors of Ten-Year Event-Free Survival in Patients With Acute Myocardial Infarction (from the Adria, Bassano, Conegliano, and Padova Hospitals [ABC] Study on Myocardial Infarction)

Berton, Giuseppe; Cordiano, Rocco; Cavuto, Fiorella; Giacomini, Giulia; Toni, Renzo De; Palatini, Paolo

doi:10.1016/j.amjcard.2011.11.026

Cited by 13 publications

(13 citation statements)

References 24 publications

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“…Another study aim was to investigate the prognostic value of multiple baseline clinical variables. Criteria for ACS diagnosis included the clinical presentation, electrocardiogram findings, and the presence of serum biochemical markers of necrosis [16, 17].…”

Section: Methodsmentioning

confidence: 99%

Association between plasma lipid levels during acute coronary syndrome and long-term malignancy risk. The ABC-4* study on heart disease

Berton

Cordiano²,

Cavuto

et al. 2019

BMC Cardiovasc Disord

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Background Emerging evidence suggests that patients with coronary artery disease carry an increased risk of developing malignancy, with deleterious effects on long-term prognosis. Our aim was to ascertain whether baseline plasma lipid levels during acute coronary syndrome (ACS) are associated with malignancy in long-term. Methods This study included 589 patients admitted with ACS to three centers and discharged alive. Plasma lipid levels were assessed on the first morning after admission. Patients were followed for 17 years or until death. Results Five hundred seventy-one patients were free from malignancy at enrollment, of them 99 (17.3%) developed the disease during follow-up and 75 (13.1%) died due to it. Compared to patients without malignancy, those with malignancy showed lower plasma levels of total cholesterol (TC), low-density lipoprotein (LDL), and triglycerides (TG). The groups showed similar statin use rates at any time in follow-up. The incidence rate of neoplasia and neoplastic mortality was higher in patients with baseline TC or LDL values ≤ median; they showed 85 and 72% increased incidence rate of developing malignancy and 133 and 122% increased incidence rate of neoplastic death respectively. No differences were observed relative to HDL and TG levels. In survival analysis using Cox regression with parsimonious models, patients with baseline TC or LDL values > median, respectively, showed risks of 0.6(95% CI 0.4–0.9; p = 0.01) and 0.6(95%CI 0.4–0.9; p = 0.02) for malignancy onset, and 0.5(95% CI 0.3–0.8; p = 0.005) and 0.5(95% CI 0.3–0.8; p = 0.004) for neoplastic death. Similar results were obtained using competitive risk analysis with parsimonious models. Conclusions This long-term prospective study of an unselected real-world patient sample showed that neoplasia onset and mortality are independently associated with low plasma TC and LDL levels at admission for ACS.

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Section: Methodsmentioning

confidence: 99%

Association between plasma lipid levels during acute coronary syndrome and long-term malignancy risk. The ABC-4* study on heart disease

Berton

Cordiano²,

Cavuto

et al. 2019

BMC Cardiovasc Disord

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“…Another study aim was to investigate the prognostic value of multiple baseline clinical variables. Criteria for acute coronary syndrome diagnosis included clinical presentation, electrocardiogram findings and the presence of serum biochemical markers of necrosis 11,12 …”

Section: Methodsmentioning

confidence: 99%

“…In all three hospitals, plasma lipid measurements were performed using an enzymatic colorimetric method 14 . Details of the measured variables were published previously 11,12 …”

Section: Methodsmentioning

confidence: 99%

Baseline plasma lipid levels in patients with acute coronary syndrome: Association with 20‐year mortality. The ABC‐5a* Study on Heart Disease

Berton

Cordiano²,

Mahmoud

et al. 2020

Int J Clin Pract

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Background The relationship between baseline plasma lipid levels during acute coronary syndrome and the outcome has clinical relevance. Methods To evaluate their long‐term prognostic value, we examined 589 patients admitted with acute coronary syndrome at three hospitals. Baseline plasma lipids were assessed on days 1 and 7. Patients were followed for 20 years or until death. Results Virtually, all patients completed follow‐up; 437 (74%) had died: 24% from coronary artery disease/heart failure (CAD/HF), 21% sudden cardiac death (SCD), 16% from other cardiovascular causes and 39% had non‐cardiac death. The incidence rate (IR) of all‐cause mortality was not different among patients with baseline plasma lipids less or greater than the median value. The IR of CAD/HF mortality was not significantly higher among patients with greater than median low‐density lipoprotein (LDL) cholesterol and triglyceride (TG) levels. The IR of non‐cardiac death tended to be lower among patients with greater than median total cholesterol (TC) and LDL levels. Using three levels of adjusted Cox survival models, baseline plasma lipids had no consistent independent or inverse association with all‐cause mortality, even after excluding patients who received statins. Competitive risk survival models for each cause of death revealed that the only hazard of non‐cardiac death was consistently higher among patients with less than or equal to median TC and LDL levels. Conclusion In the present prospective long‐term study, after acute coronary syndrome, baseline plasma lipid levels seem not to be associated with long‐term global mortality. Only an independent inverse association between TC and LDL and non‐cardiac death has been observed.

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“…Another study aim was to investigate the prognostic value of multiple baseline clinical variables. Criteria for diagnosis of ACS included clinical presentation, electrocardiogram ndings, and the presence of serum biochemical markers of necrosis (14,15).…”

Section: Patientsmentioning

confidence: 99%

“…The ACS diagnosis criteria were the presence of at least two of the following: central chest pain lasting > 30 minutes; typical changes in serum enzymes, including total creatine kinase (CK) and creatine kinase MB (CK-MB); and typical electrocardiogram changes with pathological Q waves and/or localized ST-T changes in at least two contiguous leads (19). Details regarding the measured variables were published previously (14,15).…”

Section: Measurements and Follow-upmentioning

confidence: 99%

Risk of Malignancy Long After Acute Coronary Syndrome in Selected Urban and Rural Areas and Comparison With Smoking Risk: The ABC-7* Study on Heart Disease. (*ABC is An Acronym for Adria, Bassano, Conegliano, and Padova Hospitals)

Berton¹,

Mahmoud

Palmieri³

et al. 2020

Preprint

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Background Increased cancer risk has been reported in patients with acute coronary syndrome (ACS). Objectives To investigate geographic differences in risk malignancy long after ACS. Methods We enrolled 586 ACS patients admitted to hospitals in three provinces in the Veneto region of Italy in this prospective study. Patient's residency was classified into three urban and three nearby rural areas. Results All (except for 3) patients completed the follow-up (22 years or death) and 54% were living in rural areas. Sixteen patients had pre-existing malignancy, and 106 developed the disease during follow-up. Cancer prevalence was 17% and 24% (p=0.05) and incidence of malignancy was 16 and 21/1000 person-years for urban and rural areas, respectively. In unadjusted logistic regression analysis, cancer risk increased from urban to rural areas (odds ratio [OR] 3.4;95% confidence interval [CI] 1.7-7.1; p=0.001), with little change from north to south provinces (OR 1.5;95% CI 1.0-2.2; p=0.06). Yet, we found a strong positive interaction between urban-rural areas and provinces (OR 2.1;95% CI 1.2-3.5; p=0.003). These results kept true in the fully adjusted model. Unadjusted Cox regression analysis revealed increasing hazards ratios (HRs) for malignancy onset from urban to rural areas (HR 3.0;95% CI 1.5-6.2; p=0.02), but not among provinces (HR 1.3;95% CI 1.0-2.0; p=0.14). Also, we found a strong positive interaction between geographic areas (HR 2.1;95% CI 1.3-3.5; p=0.002), even with a fully adjusted model. Conclusion The results in unselected real-world patients demonstrate a significant geographic difference in malignancy risk in ACS patients, with the highest risk in the north-rural area.

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Predictors of Ten-Year Event-Free Survival in Patients With Acute Myocardial Infarction (from the Adria, Bassano, Conegliano, and Padova Hospitals [ABC] Study on Myocardial Infarction)

Cited by 13 publications

References 24 publications

Association between plasma lipid levels during acute coronary syndrome and long-term malignancy risk. The ABC-4* study on heart disease

Association between plasma lipid levels during acute coronary syndrome and long-term malignancy risk. The ABC-4* study on heart disease

Baseline plasma lipid levels in patients with acute coronary syndrome: Association with 20‐year mortality. The ABC‐5a* Study on Heart Disease

Risk of Malignancy Long After Acute Coronary Syndrome in Selected Urban and Rural Areas and Comparison With Smoking Risk: The ABC-7* Study on Heart Disease. (*ABC is An Acronym for Adria, Bassano, Conegliano, and Padova Hospitals)

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Predictors of Ten-Year Event-Free Survival in Patients With Acute Myocardial Infarction (from the Adria, Bassano, Conegliano, and Padova Hospitals [ABC] Study on Myocardial Infarction)

Cited by 13 publications

References 24 publications

Association between plasma lipid levels during acute coronary syndrome and long-term malignancy risk. The ABC-4* study on heart disease

Association between plasma lipid levels during acute coronary syndrome and long-term malignancy risk. The ABC-4* study on heart disease

Baseline plasma lipid levels in patients with acute coronary syndrome: Association with 20‐year mortality. The ABC‐5a* Study on Heart Disease

Risk of Malignancy Long After Acute Coronary Syndrome in Selected Urban and Rural Areas and Comparison With Smoking Risk:&nbsp;The ABC-7* Study on Heart Disease.&nbsp;(*ABC is An Acronym for Adria, Bassano, Conegliano, and Padova Hospitals)

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Risk of Malignancy Long After Acute Coronary Syndrome in Selected Urban and Rural Areas and Comparison With Smoking Risk: The ABC-7* Study on Heart Disease. (*ABC is An Acronym for Adria, Bassano, Conegliano, and Padova Hospitals)