Author:
Djallalludin ,Wijaya Ika Prasetya,Koesnoe Sukamto,Alwi Idrus
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.