ISSN: 2451-0629
Archives of Medical Science - Atherosclerotic Diseases
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Official journal of the International Lipid Expert Panel (ILEP)
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vol. 6
 
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abstract:
Clinical research

Eccentric hypertrophy predicts adverse events in patients undergoing percutaneous coronary intervention for acute coronary syndrome

Edward T. Ha
1
,
Marc Cohen
2, 3
,
Stephen J. Peterson
1, 4
,
Wilbert S. Aronow
5, 6

1.
Department of Internal Medicine, New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, USA
2.
Department of Cardiology, Newark Beth Israel Medical Center, Newark, NJ, USA
3.
Department of Medicine, Rutgers-New Jersey Medical School, Newark, NJ, USA
4.
Department of Medicine, Weill Cornell Medical College, New York, NY
5.
Department of Medicine, New York Medical College, Valhalla, NY, USA
6.
Department of Cardiology, Westchester Medical Center, Valhalla, NY, USA
Arch Med Sci Atheroscler Dis 2021; 6: e21–e27
Online publish date: 2021/04/09
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Introduction
The effect of the type of left ventricular hypertrophy in patients presenting with an acute coronary syndrome (ACS) on long-term outcomes is ill-defined. The purpose of this study was to investigate the prognostic effect of concentric (CH) or eccentric hypertrophy (EH) on adverse outcomes in patients presenting with ACS undergoing percutaneous coronary intervention (PCI).

Material and methods
We analyzed 1-year follow-up data from a single-institution, retrospective, observational study that enrolled 1,153 patients who presented with ACS and were treated with PCI, for whom echocardiographic data were available.

Results
Normal geometry was observed in 718 (62.3%) patients, while 27.2% had CH and 10.5% had EH. The primary endpoint of all-cause death (n = 90, 7.8%) occurred in 6.4%, 8.0%, and 14.9% of patients with no, concentric, or eccentric hypertrophy, respectively (p = 0.005). Major adverse cardiac events (MACE – all-cause death, non-fatal myocardial infarction or stroke or hospitalization for bleeding) occurred in 13.9%, 17.8%, 30.6%, respectively (p < 0.001). Age (HR per year = 1.04 (1.02, 1.05), p < 0.001), female gender (HR = 1.56 (1.12, 2.16), p = 0.008), diabetes (HR = 1.49 (1.07, 2.06), p = 0.02), eccentric hypertrophy (HR = 1.58 (1.006, 2.47), p = 0.047), peak troponin I (HR per 1 ng/ml = 1.004 (1.001, 1.006), p = 0.004) and left ventricular ejection fraction < 50% (HR = 1.57 (1.12, 2.20), p < 0.008) were significant predictors of MACE.

Conclusions
The presence of eccentric hypertrophy in ACS patients undergoing PCI is an independent predictor of adverse outcomes at 1 year.

keywords:

heart failure, myocardial infarction, left ventricular hypertrophy, major adverse cardiac events, heart attack

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