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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MDPI AG
2025-06-01
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| 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. |
| format | Article |
| id | doaj-art-ec7dfe18a731425da42a219f68922f99 |
| institution | Kabale University |
| issn | 2308-3425 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | MDPI AG |
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| series | Journal of Cardiovascular Development and Disease |
| 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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