Long-term prognosis of adverse cardiovascular events in patients with acute coronary syndrome after percutaneous coronary interventions

• Olga N. Kurochkina
• Dmitry A. Korotkov
• Andrey N. Bogomolov
• Kirill L. Kozlov
• Kirill S. Boltunov

Abstract

Background. Percutaneous coronary intervention (PCI) is the main revascularization strategy for acute coronary syndrome (ACS) treatment. It is important to determine the factors influencing on the development of major adverse cardiac events in the long-term period in patients with ACS and PCI.

Aim – assessment of the incidence of adverse cardiovascular events in patients with acute coronary syndrome within 3 years after percutaneous coronary intervention.

Material and methods. The medical records of patients with ACS who underwent PCI for 2019 were studied. The study included 100 patients – 76 men and 24 women. The average age of the patients was 56.7±10.3 years. The discharge diagnosis was formulated as myocardial infarction (MI) (81% of cases) or unstable angina (UA) (19% of cases). Information about the long-term consequences after PCI for 3 years was obtained from the RIAMS electronic database. We studied adverse outcomes (MACE) that occurred in the long-term period after PCI, which included unstable angina, acute myocardial infarction, acute cerebrovascular accident, and death. All data were entered into the table in Excel format. Data processing was carried out using Excel and Xlstat statistical software. The correlation between various factors and MACE was estimated using the linear regression method, the construction of a predictive model was carried out using the method of multivariate regression analysis. The p<0.05 values were considered as statistically significant.

Results. Charlson’s comorbidity index was 47.1±30.8 points. MACE within 3 years after PCI included 7 (18%) cases of death, 20 (53%) – unstable angina, 5 (13%) – myocardial infarction, 6 (16%) – acute cerebrovascular accident. Adverse outcomes over 3 years were associated with hemoglobin level (p=0.001), age (p=0.01) and Charlson’s comorbidity index (p=0.01). A prognostic model for assessing the risk of cardiovascular events after PCI has been created.

Conclusions. Risk factors for adverse long-term outcomes in patients with ACS after PCI were identified. These factors included low hemoglobin levels, age, and comorbidity index. Patients with such risk factors require more careful monitoring and treatment on an outpatient basis.

Keywords:acute coronary syndrome; percutaneous coronary interventions; long-term survival; old age; Charleson’s comorbidity index; combined endpoints

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