serval:BIB_535BD91177FC
Prognosis of cardiovascular and non-cardiovascular multimorbidity after acute coronary syndrome.
10.1371/journal.pone.0195174
000429791900031
29649323
Canivell
S.
author
Muller
O.
author
Gencer
B.
author
Heg
D.
author
Klingenberg
R.
author
Räber
L.
author
Carballo
D.
author
Matter
C.
author
Lüscher
T.
author
Windecker
S.
author
Mach
F.
author
Rodondi
N.
author
Nanchen
D.
author
article
2018
PloS one
1932-6203
1932-6203
journal
13
4
e0195174
To examine the prognosis of patients with cardiovascular and non-cardiovascular multimorbidity after acute coronary syndrome compared to patients without prior multimorbidity.
This multicenter prospective cohort study in Switzerland included 5,635 patients hospitalized with acute coronary syndrome between 2009 and 2014, with a one-year follow-up period. We defined cardiovascular and non-cardiovascular multimorbidity as having at least two prior comorbidities before the index hospitalization. Multivariable adjusted Cox proportional models were built to assess the one-year risk of recurrent cardiovascular events, defined as cardiovascular mortality and non-fatal myocardial infarction or stroke. The final model was adjusted for age, gender, body mass index, tobacco consumption, education, and family history of cardiovascular disease, prescription of high-dose statinsat discharge and use of cardiac rehabilitation after discharge.
Overall, 3,664 patients (65%) had no multimorbidity, 1,839 (33%) had cardiovascular multimorbidity, 62 (1%) had non-cardiovascular multimorbidity, and 70 (1%) had both cardiovascular and non-cardiovascular multimorbidity. The multivariate risk of recurrent cardiovascular events was increased among patients with cardiovascular multimorbidity (hazard ratio (HR) 2.05, 95% CI: 1.54-2.73, p<0.001) and patients with non-cardiovascular multimorbidity (HR 2.57, 95% CI: 1.04-6.35, p = 0.04) compared to patients without multimorbidity. Patients with cardiovascular and non-cardiovascular multimorbidity had the highest risk of recurrence with a HR of 5.19, 95% CI: 2.79-9.64, p<0.001, compared to patients without multimorbidity.
Multimorbidity increased by two-fold the risk of cardiovascular events over the year after an acute coronary syndrome. The magnitude of this increased risk was similar for patients with cardiovascular or non-cardiovascular multimorbidity.
Acute Coronary Syndrome/complications
Acute Coronary Syndrome/diagnosis
Acute Coronary Syndrome/mortality
Aged
Aged, 80 and over
Cardiovascular Diseases/complications
Cardiovascular Diseases/mortality
Female
Hospitalization
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use
Male
Middle Aged
Multimorbidity
Multivariate Analysis
Prognosis
Proportional Hazards Models
Prospective Studies
Recurrence
Risk Factors
Treatment Outcome
eng
60_published
true
peer-reviewed
Publication types: Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
Publication Status: epublish
University of Lausanne
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