Predictors of Five-Year Outcomes in Patients with Acute Coronary Syndromes

Background: Residual risk after acute coronary syndromes (ACSs) continues to affect prognosis. We investigated the impact of female sex, non-ST-segment–elevation myocardial infarction (NSTEMI), diabetes mellitus (DM), and chronic kidney disease (CKD) on coronary atherosclerosis extent, culprit steno...

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Main Authors: Luca Di Vito, Giancarla Scalone, Federico Di Giusto, Filippo Bruscoli, Simona Silenzi, Adelina Selimi, Arianna Massari, Domenico Delfino, Federico Guerra, Pierfrancesco Grossi
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Journal of Cardiovascular Development and Disease
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Online Access:https://www.mdpi.com/2308-3425/12/6/234
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author Luca Di Vito
Giancarla Scalone
Federico Di Giusto
Filippo Bruscoli
Simona Silenzi
Adelina Selimi
Arianna Massari
Domenico Delfino
Federico Guerra
Pierfrancesco Grossi
author_facet Luca Di Vito
Giancarla Scalone
Federico Di Giusto
Filippo Bruscoli
Simona Silenzi
Adelina Selimi
Arianna Massari
Domenico Delfino
Federico Guerra
Pierfrancesco Grossi
author_sort Luca Di Vito
collection DOAJ
description Background: Residual risk after acute coronary syndromes (ACSs) continues to affect prognosis. We investigated the impact of female sex, non-ST-segment–elevation myocardial infarction (NSTEMI), diabetes mellitus (DM), and chronic kidney disease (CKD) on coronary atherosclerosis extent, culprit stenosis location, and bio-humoral data. The rate of both major adverse cardiovascular events (MACE) and non-fatal recurrent coronary events (RCE) was additionally evaluated. Methods: We enrolled 1404 ACS patients and followed them for up to 5 years. Coronary culprit and non-culprit stenoses were analyzed using angiography. Biohumoral data was assessed at admission and at 1 month and 12 months after discharge. Patients were compared based on sex, NSTEMI, DM, and CKD presence. Results: NSTEMI patients had a higher number of total coronary stenoses (3.5 vs. 3.3, <i>p</i> = 0.013) and non-culprit stenoses (2.3 vs. 1.6, <i>p</i> = 0.0001). Non-culprit percent stenosis was significantly greater in NSTEMI as compared to STEMI patients (57.9% vs. 47.1%, <i>p</i> = 0.0001). DM patients had a higher frequency of bifurcation lesions (41% vs. 25%, <i>p</i> = 0.0001). CKD patients showed a higher prevalence of left main disease (3.4% vs. 1.5%, <i>p</i> = 0.038). Female patients had higher LDL-cholesterol values at 1 month and 12 months. NSTEMI, DM, and creatinine level were independent predictors of MACE. NSTEMI patients had an increased risk of non-fatal RCE. Conclusions: NSTEMI, DM, and creatinine levels at admission were independent predictors of MACE in the first 5 years after an ACS.
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spelling doaj-art-ec7dfe18a731425da42a219f68922f992025-08-20T03:24:33ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252025-06-0112623410.3390/jcdd12060234Predictors of Five-Year Outcomes in Patients with Acute Coronary SyndromesLuca Di Vito0Giancarla Scalone1Federico Di Giusto2Filippo Bruscoli3Simona Silenzi4Adelina Selimi5Arianna Massari6Domenico Delfino7Federico Guerra8Pierfrancesco Grossi9Cardiology Unit, C. and G. Mazzoni Hospital, 63100 AST Ascoli Piceno, ItalyCardiology Unit, C. and G. Mazzoni Hospital, 63100 AST Ascoli Piceno, ItalyCardiology Unit, C. and G. Mazzoni Hospital, 63100 AST Ascoli Piceno, ItalyCardiology Unit, C. and G. Mazzoni Hospital, 63100 AST Ascoli Piceno, ItalyCardiology Unit, C. and G. Mazzoni Hospital, 63100 AST Ascoli Piceno, ItalyCardiology and Arrhythmology Clinic, Marche Polytechnic University of Ancona, 60121 Ancona, ItalyCardiology and Arrhythmology Clinic, Marche Polytechnic University of Ancona, 60121 Ancona, ItalyCardiology Unit, C. and G. Mazzoni Hospital, 63100 AST Ascoli Piceno, ItalyCardiology and Arrhythmology Clinic, Marche Polytechnic University of Ancona, 60121 Ancona, ItalyCardiology Unit, C. and G. Mazzoni Hospital, 63100 AST Ascoli Piceno, ItalyBackground: Residual risk after acute coronary syndromes (ACSs) continues to affect prognosis. We investigated the impact of female sex, non-ST-segment–elevation myocardial infarction (NSTEMI), diabetes mellitus (DM), and chronic kidney disease (CKD) on coronary atherosclerosis extent, culprit stenosis location, and bio-humoral data. The rate of both major adverse cardiovascular events (MACE) and non-fatal recurrent coronary events (RCE) was additionally evaluated. Methods: We enrolled 1404 ACS patients and followed them for up to 5 years. Coronary culprit and non-culprit stenoses were analyzed using angiography. Biohumoral data was assessed at admission and at 1 month and 12 months after discharge. Patients were compared based on sex, NSTEMI, DM, and CKD presence. Results: NSTEMI patients had a higher number of total coronary stenoses (3.5 vs. 3.3, <i>p</i> = 0.013) and non-culprit stenoses (2.3 vs. 1.6, <i>p</i> = 0.0001). Non-culprit percent stenosis was significantly greater in NSTEMI as compared to STEMI patients (57.9% vs. 47.1%, <i>p</i> = 0.0001). DM patients had a higher frequency of bifurcation lesions (41% vs. 25%, <i>p</i> = 0.0001). CKD patients showed a higher prevalence of left main disease (3.4% vs. 1.5%, <i>p</i> = 0.038). Female patients had higher LDL-cholesterol values at 1 month and 12 months. NSTEMI, DM, and creatinine level were independent predictors of MACE. NSTEMI patients had an increased risk of non-fatal RCE. Conclusions: NSTEMI, DM, and creatinine levels at admission were independent predictors of MACE in the first 5 years after an ACS.https://www.mdpi.com/2308-3425/12/6/234residual risksex-related differencesacute coronary syndromediabetes mellituschronic kidney disease
spellingShingle Luca Di Vito
Giancarla Scalone
Federico Di Giusto
Filippo Bruscoli
Simona Silenzi
Adelina Selimi
Arianna Massari
Domenico Delfino
Federico Guerra
Pierfrancesco Grossi
Predictors of Five-Year Outcomes in Patients with Acute Coronary Syndromes
Journal of Cardiovascular Development and Disease
residual risk
sex-related differences
acute coronary syndrome
diabetes mellitus
chronic kidney disease
title Predictors of Five-Year Outcomes in Patients with Acute Coronary Syndromes
title_full Predictors of Five-Year Outcomes in Patients with Acute Coronary Syndromes
title_fullStr Predictors of Five-Year Outcomes in Patients with Acute Coronary Syndromes
title_full_unstemmed Predictors of Five-Year Outcomes in Patients with Acute Coronary Syndromes
title_short Predictors of Five-Year Outcomes in Patients with Acute Coronary Syndromes
title_sort predictors of five year outcomes in patients with acute coronary syndromes
topic residual risk
sex-related differences
acute coronary syndrome
diabetes mellitus
chronic kidney disease
url https://www.mdpi.com/2308-3425/12/6/234
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