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Article

Long-Term Morbidity and Mortality after First and Recurrent Cardiovascular Events in the ARTPER Cohort

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Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 08303 Mataró, Spain
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Masnou Primary Healthcare Centre, Gerència d’Àmbit d’Atenció Primària Metropolitana Nord, Institut Català de la Salut, 08320 Barcelona, Spain
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Riu Nord-Riu Sud Primary Healthcare Centre, Santa Coloma de Gramenet, Gerència d’Àmbit d’Atenció Primària Metropolitana Nord, Institut Català de la Salut, 08921 Barcelona, Spain
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Department of Emergency Service, Andorran Health Care Service, Hospital Nuestra Señora de Meritxell, AD700 Escaldes-Engordany, Andorra
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La Marina Primary Healthcare Centre, Gerència d’Àmbit d’Atenció Primària Barcelona Ciutat, Institut Català de la Salut, 08038 Barcelona, Spain
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Unitat de Suport a la Recerca de l’Àmbit de l’Atenció Primària de Barcelona Ciutat, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 08007 Barcelona, Spain
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Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(12), 4064; https://doi.org/10.3390/jcm9124064
Received: 6 November 2020 / Revised: 2 December 2020 / Accepted: 10 December 2020 / Published: 16 December 2020
(This article belongs to the Special Issue Recent Advances in Coronary Artery Disease)
Background: Cardiovascular events are a major cause of mortality and morbidity worldwide. The risk of recurrence after a first cardiovascular event has been documented in the international literature, although not as extensively in a Mediterranean population-based cohort with low cardiovascular risk. There is also ample, albeit contradictory, research on the recurrence of stroke and myocardial infarctions (MI) after a first event and the factors associated with such recurrence, including the role of pathological Ankle-Brachial Index (ABI). Methods: The Peripheral Arterial ARTPER study is aimed at deepening our knowledge of patient evolution after a first cardiovascular event in a Mediterranean population with low cardiovascular risk treated at a primary care centre. We study overall recurrence, cardiac and cerebral recurrence. We studied participants in the ARTPER prospective observational cohort, excluding patients without cardiovascular events or with unconfirmed events and patients who presented arterial calcification at baseline or who died. In total, we analyzed 520 people with at least one cardiovascular event, focusing on the presence and type of recurrence, the risk factors associated with recurrence and the behavior of the ankle-brachial index (ABI) as a predictor of risk. Results: Between 2006 and 2017, 46% of patients with a first cardiovascular event experienced a recurrence of some type; most recurrences fell within the same category as the first event. The risk of recurrence after an MI was greater than after a stroke. In our study, recurrence increased with age, the presence of peripheral arterial disease (PAD), diabetes and the use of antiplatelets. Diabetes mellitus was associated with all types of recurrence. Additionally, patients with an ABI < 0.9 presented more recurrences than those with an ABI ≥ 0.9. Conclusions: In short, following a cardiac event, recurrence usually takes the form of another cardiac event. However, after having a stroke, the chance of having another stroke or having a cardiac event is similar. Lastly, ABI < 0.9 may be considered a predictor of recurrence risk. View Full-Text
Keywords: transient ischemic attack (TIA), ischemic stroke; myocardial infarction (MI), recurrent stroke; recurrent MI; peripheral arterial disease; ankle-brachial index transient ischemic attack (TIA), ischemic stroke; myocardial infarction (MI), recurrent stroke; recurrent MI; peripheral arterial disease; ankle-brachial index
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MDPI and ACS Style

Escofet Peris, M.; Alzamora, M.T.; Valverde, M.; Fores, R.; Pera, G.; Baena-Díez, J.M.; Toran, P. Long-Term Morbidity and Mortality after First and Recurrent Cardiovascular Events in the ARTPER Cohort. J. Clin. Med. 2020, 9, 4064. https://doi.org/10.3390/jcm9124064

AMA Style

Escofet Peris M, Alzamora MT, Valverde M, Fores R, Pera G, Baena-Díez JM, Toran P. Long-Term Morbidity and Mortality after First and Recurrent Cardiovascular Events in the ARTPER Cohort. Journal of Clinical Medicine. 2020; 9(12):4064. https://doi.org/10.3390/jcm9124064

Chicago/Turabian Style

Escofet Peris, Marina, Maria T. Alzamora, Marta Valverde, Rosa Fores, Guillem Pera, Jose M. Baena-Díez, and Pere Toran. 2020. "Long-Term Morbidity and Mortality after First and Recurrent Cardiovascular Events in the ARTPER Cohort" Journal of Clinical Medicine 9, no. 12: 4064. https://doi.org/10.3390/jcm9124064

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