Long-Term Prognosis of Patients with Myocardial Infarction Type 1 and Type 2 with and without Involvement of Coronary Vasospasm
Abstract
:1. Introduction
2. Experimental Section
2.1. Ethics Statement
2.2. Study Population
2.3. Clinical Outcomes and Definitions
2.4. Statistical Analysis
3. Results
3.1. Patient Background
3.1.1. Type 1 vs. Type 2
3.1.2. Type 2 with CVS vs. with Non-CVS
3.2. Clinical Outcomes
3.3. Sensitivity Analysis
4. Discussion
Study Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Acknowledgments
Conflicts of Interest
References
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Type 1 MI (n = 2834) | Type 2 MI (n = 155) | p | Type 2 MI | |||
---|---|---|---|---|---|---|
Non-CVS (n = 68) | With CVS (n = 87) | p | ||||
Age (years) | 68.7 ± 12.5 | 65.8 ± 14.4 | 0.003 | 72.4 ± 11.9 | 60.7 ± 14.5 | 0.029 |
Female (%) | 699 (24.7) | 53 (34.2) | 0.008 | 23 (33.8) | 30 (34.5) | 0.930 |
BMI (kg/m2) | 23.6 ± 3.9 | 23.1 ± 3.2 | 0.156 | 22.7 ± 3.6 | 23.2 ± 3.9 | 0.112 |
Onset to admission (min) | 345.7 ± 479.5 | 382.8 ± 553.3 | 0.062 | 337.6 ± 506.0 | 418.2 ± 588.2 | 0.381 |
HR at admission (bpm) | 79.0 ± 21.7 | 78.9 ± 19.8 | 0.340 | 83.3 ± 22.6 | 75.1 ± 16.8 | 0.033 |
Killip Class (III/IV) | 433 (15.3) | 13 (8.4) | 0.018 | 11 (16.2) | 2 (2.3) | 0.007 |
Hypertension (%) | 1885 (67.0) | 103 (66.5) | 0.886 | 44 (64.7) | 59 (67.8) | 0.910 |
Diabetes mellitus (%) | 1015 (36.6) | 40 (25.8) | 0.006 | 24 (35.3) | 16 (18.4) | 0.002 |
Dyslipidemia (%) | 1435 (51.2) | 95 (61.3) | 0.015 | 43 (63.2) | 52 (59.8) | 0.047 |
Chronic kidney disease (%) | 1261 (44.5) | 68 (43.9) | 0.876 | 43 (63.2) | 25 (28.7) | <0.001 |
Current smoking (%) | 921(33.6) | 51 (33.8) | 0.972 | 19 (27.9) | 32 (38.6) | 0.388 |
Prior MI (%) | 350 (12.4) | 18 (11.6) | 0.769 | 11 (16.2) | 7 (8.0) | 0.299 |
Prior PCI (%) | 424 (15.1) | 32 (20.6) | 0.062 | 24 (35.3) | 8(9.2) | <0.001 |
Atrial fibrillation (%) | 166 (5.6) | 12 (7.8) | 0.347 | 9 (13.4) | 3 (3.4) | 0.023 |
Prior stroke (%) | 276 (9.9) | 17 (10.9) | 0.651 | 12 (17.6) | 5 (5.8) | 0.041 |
Composite of PAD (%) | 121 (4.5) | 14 (9.4) | 0.006 | 11 (17.2) | 3 (3.5) | <0.001 |
Urgent CAG (%) | 2655 (93.8) | 130 (83.9) | <0.001 | 59 (86.8) | 71 (81.6) | <0.001 |
Max CPK (IU/L) | 2444.1 ± 2952.8 | 1065.4 ± 1828.3 | <0.001 | 1712.5 ± 2347.7 | 559.7 ± 1049.9 | <0.001 |
Hemoglobin (g/dL) | 13.7 ± 3.3 | 12.9 ± 2.5 | 0.009 | 11.7 ± 2.9 | 13.9 ± 1.7 | <0.001 |
eGFR (mL/min/1.73 m2) | 65.8 ± 45.7 | 63.6 ± 27.8 | 0.006 | 50.7 ± 27.3 | 73.7 ± 24.0 | 0.006 |
LDL-cholesterol (mg/dL) | 117.5 ± 37.8 | 100.8 ± 37.4 | <0.001 | 95.5 ± 37.1 | 104.5 ± 37.4 | <0.001 |
HDL-cholesterol (mg/dL) | 46.7 ± 13.4 | 49.8 ± 15.2 | 0.006 | 46.2 ± 14.8 | 52.6 ± 15.1 | 0.003 |
HbA1c (%) | 6.3 ± 1.4 | 5.9 ± 0.8 | <0.001 | 6.1 ± 0.8 | 5.9 ± 0.7 | <0.001 |
NSTEMI (%) | 837 (29.5) | 93 (60.0) | <0.001 | 34 (50.0) | 59 (67.8) | <0.001 |
Urgent revascularization (%) | 2,485 (87.8) | 63 (40.6) | <0.001 | 42 (61.8) | 21 (24.4) | <0.001 |
Type 1 MI (n = 2834) | Type 2 MI (n = 155) | p | Type 2 MI | |||
---|---|---|---|---|---|---|
Non-CVS (n = 68) | With CVS (n = 87) | p | ||||
Aspirin (%) | 2562 (97.3) | 70 (45.1) | <0.001 | 39 (70.9) | 54 (65.9) | 0.530 |
DAPT (%) | 2058 (78.2) | 52 (33.5) | <0.001 | 27 (49.1) | 25 (30.5) | <0.001 |
Anticoagulant Therapy (%) | 327 (12.4) | 24 (15.5) | 0.131 | 21 (36.2) | 3 (3.5) | <0.001 |
CCBs (%) | 551 (20.8) | 94 (60.6) | <0.001 | 16 (27.6) | 78 (90.7) | <0.001 |
β-blockades (%) | 1838 (70.2) | 53 (34.2) | <0.001 | 37 (64.9) | 16 (21.6) | <0.001 |
Nitrates (%) | 246 (9.5) | 37 (23.9) | <0.001 | 7 (12.7) | 30 (38.5) | <0.001 |
Nicorandil (%) | 541 (21.0) | 41 (26.4) | <0.014 | 12 (21.8) | 29 (36.3) | 0.005 |
ACE-Is (%) | 1364 (52.8) | 52 (33.5) | 0.003 | 28 (51.9) | 24 (30.8) | 0.001 |
ARBs (%) | 739 (28.5) | 41 (26.4) | 0.679 | 18 (31.6) | 23 (29.1) | 0.874 |
Diuretics (%) | 23 (0.9) | 0 (0) | NA | 0 (0) | 0 (0) | >0.990 |
Statins (%) | 2303 (87.6) | 112 (72.3) | 0.005 | 37 (67.3) | 75 (87.2) | <0.001 |
Hypoglycemic Agents (%) | 728 (27.5) | 24 (15.5) | 0.040 | 16 (27.6) | 8 (9.3) | 0.001 |
PPIs (%) | 2260 (85.5) | 92 (59.3) | <0.001 | 43 (74.1) | 49 (57.0) | <0.001 |
Variable | HR | 95% CI | P |
---|---|---|---|
Age | 1.043 | 1.026–1.060 | <0.001 |
Female | 1.270 | 0.899–1.794 | 0.175 |
BMI | 0.978 | 0.939–1.019 | 0.978 |
Killip Class | 1.986 | 1.750–2.254 | <0.001 |
Current Smoking | 1.061 | 0.731–1.540 | 0.756 |
Chronic Kidney Disease | 2.298 | 1.611–3.276 | <0.001 |
Prior PCI | 1.664 | 1.158–2.393 | 0.006 |
Composite of PAD | 2.045 | 1.203–3.475 | 0.008 |
Urgent Revascularization | 0.737 | 0.441–1.230 | 0.243 |
Multivessel Disease | 1.365 | 1.004–1.858 | 0.047 |
Variable | HR | 95% CI | P |
---|---|---|---|
Age | 1.080 | 0.996–1.171 | 0.061 |
Heart Rate | 1.040 | 0.999–1.081 | 0.053 |
Killip Class | 0.814 | 0.355–1.871 | 0.629 |
Chronic Kidney Disease | 1.144 | 0.242–5.410 | 0.865 |
Prior CABG | 1.511 | 0.080–28.567 | 0.783 |
Urgent Revascularization | 5.085 | 1.018–25.390 | 0.047 |
Multivessel Disease | 5.395 | 1.186–24.545 | 0.029 |
Hemoglobin | 0.992 | 0.712–1.384 | 0.964 |
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Sato, R.; Sakamoto, K.; Kaikita, K.; Tsujita, K.; Nakao, K.; Ozaki, Y.; Kimura, K.; Ako, J.; Noguchi, T.; Yasuda, S.; et al. Long-Term Prognosis of Patients with Myocardial Infarction Type 1 and Type 2 with and without Involvement of Coronary Vasospasm. J. Clin. Med. 2020, 9, 1686. https://doi.org/10.3390/jcm9061686
Sato R, Sakamoto K, Kaikita K, Tsujita K, Nakao K, Ozaki Y, Kimura K, Ako J, Noguchi T, Yasuda S, et al. Long-Term Prognosis of Patients with Myocardial Infarction Type 1 and Type 2 with and without Involvement of Coronary Vasospasm. Journal of Clinical Medicine. 2020; 9(6):1686. https://doi.org/10.3390/jcm9061686
Chicago/Turabian StyleSato, Ryota, Kenji Sakamoto, Koichi Kaikita, Kenichi Tsujita, Koichi Nakao, Yukio Ozaki, Kazuo Kimura, Junya Ako, Teruo Noguchi, Satoshi Yasuda, and et al. 2020. "Long-Term Prognosis of Patients with Myocardial Infarction Type 1 and Type 2 with and without Involvement of Coronary Vasospasm" Journal of Clinical Medicine 9, no. 6: 1686. https://doi.org/10.3390/jcm9061686