Skip to main content Skip to main navigation menu Skip to site footer

Predictors of major adverse cardiac events during 7-days period in acute coronary syndrome patients who had percutaneous coronary intervention in Cipto Mangunkusumo National Hospital, Jakarta

  • Djallalludin ,
  • Ika Prasetya Wijaya ,
  • Sukamto Koesnoe ,
  • Idrus Alwi ,


Abstract

Link of Video Abstract: https://youtu.be/YDWnVBBGC0Q

 

Background: Major adverse cardiac events (MACE) increase the morbidity and mortality of patients with acute coronary syndrome (ACS). Data are lacking on MACE occurrence in patients with ACS after percutaneous coronary intervention (PCI). This study aims to find out the predictors of MACE during 7 days in ACS patients who had PCI.

Methods: The study design was unmatched case-control. The study included 461 patients with ACS who were hospitalized in the intensive cardiology care unit in Cipto Mangunkusumo Hospital from January 1st, 2015 until November 30th, 2017. Age, female sex, diabetes mellitus, hypertension, heart failure, kidney function disorder, cardiogenic shock, ejection fraction ≤ 40%, left main (LM) coronary artery stenosis, arrhythmia, 3-vessel coronary artery stenosis, and left anterior descending (LAD) artery stenosis were included in the analysis as predictors of MACE.

Results: Cardiogenic shock (OR = 10.65, p = 0.001), LAD stenosis (OR = 15.23, p = 0.02), ejection fraction ≤ 40% (OR = 10.8, p = 0.00), 3-vessels or more coronary artery stenosis (OR 3.47, p = 0.01), heart failure (OR = 3.1, p = 0.02), and renal function disorder (OR 4.76, p = 0.00) were proven as predictors of MACE during 7-days period in ACS patients who had PCI. Female sex, cardiogenic shock, LAD stenosis, and ejection fraction ≤ 40% were independent predictors of MACE in ACS patients who had PCI, with OR values of 6.33 (95%CI 1.32- 30.50), OR 17.56 (1.85-167.06), OR 26.61 (1.38-513.81), and OR 7.6 (1.86-31.09), respectively.

Conclusion: Cardiogenic shock, LAD stenosis, ejection fraction ≤ 40%, ≥ 3 vessels stenosis, heart failure, and renal function disorder were predictors of MACE during 7 days in ACS patients who had PCI.

Keywords: acute coronary syndrome major adverse cardiac events percutaneous coronary intervention predictors

References

  1. Sanchis-Gomar F, Perez-Quilis C, Leischik R, Lucia A. Epidemiology of coronary heart disease and acute coronary syndrome. Ann Transl Med. 2016;4(13):256. Available from: https://pubmed.ncbi.nlm.nih.gov/27500157
  2. Collaborators GBD 2013 M and C of D. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014/12/18. 2015;385(9963):117–71. Available from: https://pubmed.ncbi.nlm.nih.gov/25530442
  3. Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: A systematic analysis for the Global Burden of Disease Study 2010. The Lancet. 2012;380(9859):2095–128.
  4. Rana O. Percutaneous coronary intervention in the very elderly (≥85 years): trends and outcomes. British Journal of Cardiology. 2013; Available from: http://dx.doi.org/10.5837/bjc.2013.006
  5. Mendis Shanthi, Puska P, Norrving Bo, World Health Organization., World Heart Federation., World Stroke Organization. Global atlas on cardiovascular disease prevention and control. World Health Organization in collaboration with the World Heart Federation and the World Stroke Organization; 2011. 155 p.
  6. Xu J, Murphy SL, Kochanek KD, Bastian BA. Deaths: Final Data for 2013. Natl Vital Stat Rep. 2016;64(2):1–119.
  7. Simms AD, Batin PD, Kurian J, Durham N, Gale CP. Acute coronary syndromes: an old age problem. J Geriatr Cardiol. 2012;9(2):192–6. Available from: https://pubmed.ncbi.nlm.nih.gov/22934104
  8. Townsend N, Wilson L, Bhatnagar P, Wickramasinghe K, Rayner M, Nichols M. Cardiovascular disease in Europe: epidemiological update 2016. Eur Heart J. 2016;37(42):3232–45. Available from: http://dx.doi.org/10.1093/eurheartj/ehw334
  9. Kementerian Kesehatan RI. Laporan Riskesdas 2018. Laporan Nasional Riskesdas 2018. 2018;53(9):154–65.
  10. Kesehatan K, Indonesia R, Bahasa P, Dan V, Struktur M, Tugas O, et al. Gambaran penyakit tidak menular di rumah sakit tahun 2009 dan 2010 [Internet]. 2012. Available from: https://www.kemkes.go.id/article/view/13010200029/download-pusdatin-buletin-ptm.html
  11. Smith JN, Negrelli JM, Manek MB, Hawes EM, Viera AJ. Diagnosis and Management of Acute Coronary Syndrome: An Evidence-Based Update. The Journal of the American Board of Family Medicine. 2015;28(2):283–93. Available from: http://dx.doi.org/10.3122/jabfm.2015.02.140189
  12. Singh M, Peterson ED, Roe MT, Ou F-S, Spertus JA, Rumsfeld JS, et al. Trends in the Association Between Age and In-Hospital Mortality After Percutaneous Coronary Intervention. Circ Cardiovasc Interv. 2009;2(1):20–6. Available from: http://dx.doi.org/10.1161/circinterventions.108.826172
  13. Panduranga P, Al-Rashidi M, Al-Hajri F. In-Hospital and One-Year Clinical Outcome of Percutaneous Coronary Intervention in a Tertiary Hospital in Oman: Oman PCI Registry. Oman Med J. 2017;32(1):54–61. Available from: https://pubmed.ncbi.nlm.nih.gov/28042404
  14. Maliawan RP, Idarto D, Yasmin ADA, Gunadhi IP. Hyperuricemia as predictor of in-hospital major adverse cardiac events in patients with acute myocardial infarction treated at Sanglah General Hospital, Denpasar-Bali. Bali Medical Journal. 2017;6(2):395.
  15. Halkin A, Singh M, Nikolsky E, Grines CL, Tcheng JE, Garcia E, et al. Prediction of Mortality After Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction. J Am Coll Cardiol. 2005;45(9):1397–405. Available from: http://dx.doi.org/10.1016/j.jacc.2005.01.041
  16. Wongpraparut N, Md P, Tresukosol D, Chotinaiwattarakul C, Phankingthongkum R, Tungsubutra W, et al. Predictors of In-Hospital Adverse Events after PCI for NSTEMI in the National Percutaneous Coronary Intervention (PCI) Registry. Vol. 97, J Med Assoc Thai. 2014.
  17. Wolfrum M, Fahrni G, de Maria GL, Knapp G, Curzen N, Kharbanda RK, et al. Impact of impaired fractional flow reserve after coronary interventions on outcomes: a systematic review and meta-analysis. BMC Cardiovasc Disord. 2016;16(1):177. Available from: https://pubmed.ncbi.nlm.nih.gov/27608682
  18. Madhavan M V., Tarigopula M, Mintz GS, Maehara A, Stone GW, Généreux P. Coronary artery calcification: Pathogenesis and prognostic implications. Vol. 63, Journal of the American College of Cardiology. Elsevier USA; 2014. p. 1703–14.
  19. Moeswir D, Alwi A, Nasution S, Abdullah M. Skor prediksi major adverse cardiac events tujuh ari pada pasien sindrom koroner akut. 2014.
  20. Han Cheol L, Sup PJ, Hoon CJ, Kim SP, Keun LT, Sang LJ. Prognosis According to The Timing Of Percutaneous Coronary Intervention in Non-ST Segment Elevation Myocardial Infarction: Based on The Korean Acute Myocardial Infarction Registry: PP.22.412. J Hypertens. 2010;28:e368. Available from: http://dx.doi.org/10.1097/01.hjh.0000379338.25451.b7
  21. Ehsan MA, Mahmood MM, Khan LF, Salim MA. Prediction of major adverse cardiac events of patients with acute coronary syndrome by using TIMI risk index. Journal of Dhaka National Medical College & Hospital. 2013;18(2):52–7. Available from: http://dx.doi.org/10.3329/jdnmch.v18i2.16024
  22. Abbasi K, Porhoseini H, Sadeghian S, Abbasi SH, Sharafi A, Abbasi A. P-386 In-Hospital and Mid-Term Outcomes of Following Percutaneous Coronary Intervention in Patients >65 Years Old Comparing to Younger Patients. CVD Prev Control. 2009;4:S161. Available from: http://dx.doi.org/10.1016/s1875-4570(09)60578-7
  23. Berger JS, Elliott L, Gallup D, Roe M, Granger CB, Armstrong PW, et al. Sex differences in mortality following acute coronary syndromes. JAMA. 2009;302(8):874–82. Available from: https://pubmed.ncbi.nlm.nih.gov/19706861
  24. McManus DD, Gore J, Yarzebski J, Spencer F, Lessard D, Goldberg RJ. Recent trends in the incidence, treatment, and outcomes of patients with STEMI and NSTEMI. Am J Med. 2011;124(1):40–7. Available from: https://pubmed.ncbi.nlm.nih.gov/21187184
  25. Bauer T, Möllmann H, Weidinger F, Zeymer U, Seabra-Gomes R, Eberli F, et al. Predictors of hospital mortality in the elderly undergoing percutaneous coronary intervention for acute coronary syndromes and stable angina. Int J Cardiol. 2011;151(2):164–9. Available from: http://dx.doi.org/10.1016/j.ijcard.2010.05.006
  26. Lindsey JB, House JA, Kennedy KF, Marso SP. Diabetes Duration Is Associated With Increased Thin-Cap Fibroatheroma Detected by Intravascular Ultrasound With Virtual Histology. Circ Cardiovasc Interv. 2009;2(6):543–8. Available from: http://dx.doi.org/10.1161/circinterventions.109.876672
  27. Santos JCMD, Rocha M de S, Araújo M da S. Prognostic Factors in Patients with Acute Coronary Syndrome without ST Segment Elevation. Arq Bras Cardiol. 2013; Available from: http://dx.doi.org/10.5935/abc.20130077
  28. Mi S-H, Su G, Yang H-X, Zhou Y, Tian L, Zhang T, et al. Comparison of in-hospital glycemic variability and admission blood glucose in predicting short-term outcomes in non-diabetes patients with ST elevation myocardial infarction underwent percutaneous coronary intervention. Diabetol Metab Syndr. 2017;9:20. Available from: https://pubmed.ncbi.nlm.nih.gov/28344659
  29. Tsai I-T, Wang C-P, Lu Y-C, Hung W-C, Wu C-C, Lu L-F, et al. The burden of major adverse cardiac events in patients with coronary artery disease. BMC Cardiovasc Disord. 2017;17(1):1. Available from: https://pubmed.ncbi.nlm.nih.gov/28052754
  30. Chong E, Shen L, Tan HC, Poh KK. A cohort study of risk factors and clinical outcome predictors for patients presenting with unstable angina and non ST segment elevation myorardial infraction undergoing coronary intervention. Med J Malaysia. 2011;66(3):249–52. Available from: https://pubmed.ncbi.nlm.nih.gov/22111450/
  31. Burjonroppa SC, Varosy PD, Rao S V, Ou F-S, Roe M, Peterson E, et al. Survival of Patients Undergoing Rescue Percutaneous Coronary Intervention. JACC Cardiovasc Interv. 2011;4(1):42–50. Available from: http://dx.doi.org/10.1016/j.jcin.2010.09.020
  32. Kassaian S-E, Saroukhani S, Alaeddini F, Salarifar M, Capodanno D, Poorhoseini H, et al. A Risk-Scoring Model to Predict One-year Major Adverse Cardiac Events after Percutaneous Coronary Intervention. J Teh Univ Heart Ctr. 2015;10(4):167–75.
  33. Almeida I, Caetano F, Barra S, Madeira M, Mota P, Leitão-Marques A. Estimating glomerular filtration rate in acute coronary syndromes: Different equations, different mortality risk prediction. Eur Heart J Acute Cardiovasc Care. 2015;5(3):223–30. Available from: http://dx.doi.org/10.1177/2048872615576219
  34. Limbong M, Herry Y, Ardhianto P, Suhartono. Risk score of contrast-induced nephropathy in patients after percutaneous coronary intervention. Bali Medical Journal. 2021;10(1):400–4.
  35. Maliawan RPI, Nadha IKB, Widiana IGR, Gunadhi IGNP, Iswari IS, Wita IW. Serum neutrophil gelatinase-associated lipocalin and decreased kidney function as predictor of mortality and major adverse cardiac events during acute heart failure hospitalizations. Bali Medical Journal. 2021;10(2):857–62.
  36. Falk E. Pathogenesis of Atherosclerosis. J Am Coll Cardiol. 2006;47(8):C7–12. Available from: http://dx.doi.org/10.1016/j.jacc.2005.09.068
  37. Bundhoo SS, Kalla M, Anantharaman R, Morris K, Chase A, Smith D, et al. Outcomes following PCI in patients with previous CABG. Catheterization and Cardiovascular Interventions. 2011;78(2):169–76. Available from: http://dx.doi.org/10.1002/ccd.22841
  38. Sadrnia S, Khosravi A, Pourmoghaddas M, Hadizadeh M, Maghamimehr A, Esmaeeli M, et al. Factors affecting outcome of primary percutaneous coronary intervention for acute myocardial infarction. ARYA Atheroscler. 2013;9(4):241–6. Available from: www.mui.ac.ir30Jun
  39. Quarella M, Toggweiler S, Müller DJ, Wyss CA, Corti R, Lüscher TF. Single-vessel versus multivessel PCI in patients with acute coronary syndrome and multivessel coronary artery disease. Cardiovasc Med. 2011;14(05):141–7. Available from: http://dx.doi.org/10.4414/cvm.2011.01593

How to Cite

Djallalludin, Wijaya, I. P. ., Koesnoe, S. ., & Alwi, I. . (2023). Predictors of major adverse cardiac events during 7-days period in acute coronary syndrome patients who had percutaneous coronary intervention in Cipto Mangunkusumo National Hospital, Jakarta. Bali Medical Journal, 12(3), 2386–2391. https://doi.org/10.15562/bmj.v12i3.4658
ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver
Download Citation
Endnote/Zotero/Mendeley (RIS) BibTeX

HTML
1

Total
1

Share

Search Panel

Djallalludin
Google Scholar
Pubmed
BMJ Journal

Ika Prasetya Wijaya
Google Scholar
Pubmed
BMJ Journal

Sukamto Koesnoe
Google Scholar
Pubmed
BMJ Journal

Idrus Alwi
Google Scholar
Pubmed
BMJ Journal