Tuinman, A.C. (2022) Prediction model for Major Adverse Cardiovascular Events and Hospitilazation for Heart Failure in Non-ST Elevated Myocardial Infarct. thesis, Medicine.
Full text available on request.Abstract
Introduction Acute coronary syndrome (ACS) is one of the most frequent complications of coronary artery disease and a major health care burden. Nowadays 70% of all ACS is due to non-ST elevation myocardial infarction (NSTEMI). Patients differ in characteristics and outcome from ST elevation myocardial infraction (STEMI). Predictors of clinical outcome in STEMI have been well established, but much less is known about risk predictors specifically in patients with NSTEMI. Methods In this prospective single-center observational study 269 patients who underwent coronary angiography in the University of Groningen Medical Centre from July 2015 till March 2020 were analyzed. A multivariable Cox regression model was developed to predict the occurrence of major adverse cardiovascular events (MACE) and hospitalization for heart failure (HFH). The performance of the model was evaluated using C-statistics. Results. Mean age of the study population was 65.4 years and 29.4% was female. During a median follow-up of 3.37 years a total of 77 (28.6%) patients experienced MACE and 13 (5.9%) patients were hospitalized for heart failure. Independent predictors of a higher risk of MACE were a history of renal dysfunction (HR = 2.84 95% CI 1.00 – 8.07, p = 0.049), an baseline medication of a beta blocker (HR = 2.46 95% CI 1.40 – 4.32, p = 0.002) and nitrates (HR = 2.12 95% CI 1.11 – 4.05, p = 0.023) C-statistics of the risk model was 0.66. Independent predictors of a higher risk of the combined endpoint is MACE/HF were baseline medication of a beta blocker (HR = 3.49 95% CI 2.04 – 5.98, p < 0.001 ) and potassium sparing diuretics (HR = 4.18 95% CI 1.62 – 10.79, p = 0.003), male (HR = 2.00 95% CI 1.05 – 3.57, p = 0.035) and lower hemoglobin at admission (HR = 1.43 95% CI 1.06 – 1.89, p = 0.016). C-statistics for this model was 0.70. Conclusion. In conclusion, specific risk predictors for major adverse cardiac events and heart failure hospitalization in patients with a NSTEMI were identified. Key words: Non-ST elevated Myocardial Infarction (NSTEMI), Heart Failure, Major Adverse Cardiovascular Events, Prediction model
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Prof. Dr. Voors, A,A, and Drs. van Dorp, P. and Dr. Lipsic, E. |
| Faculty: | Medical Sciences |
| Date Deposited: | 12 Jul 2023 11:10 |
| Last Modified: | 12 Jul 2023 11:10 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3581 |
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