Tsung-Lin Yang1,2,3, Chin-Chou Huang1,3,4,5, Shao-Sung Huang1,3,6,7, Chun-Chih Chiu1,3,6, Hsin-Bang Leu1,3,6,7, Shing-Jong Lin1,3,4,6,7. 1. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital. 2. Division of Cardiology, Department of Internal Medicine, Taipei Medical University Hospital. 3. Cardiovascular Research Center, National Yang-Ming University. 4. Department of Medical Research and Education, Taipei Veterans General Hospital. 5. Institute of Pharmacology. 6. Institute of Clinical Medicine, National Yang-Ming University. 7. Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan.
Abstract
BACKGROUND: To date, it remains unsettled whether aortic arch calcification (AAC) has prognostic value in patients with acute coronary syndrome. METHODS: From January 1 to December 31, 2013, a total of 225 patients with acute coronary syndrome (mean age 72 ± 26 years, 75% male) were enrolled in this study. Patients admitted to the coronary care unit of a tertiary referral medical center under the preliminary diagnosis of acute coronary syndrome were retrospectively investigated. The primary endpoint was composite of long-term major adverse cardiovascular events. The secondary endpoints were 30-day and long-term all-cause mortality. RESULTS: Of the 225 patients enrolled in this study, 143 had detectable AAC. Those who had AAC were older, with higher Killip classification and thrombolysis in myocardial infarction (TIMI) score with a lower probability of single vessel disease. Acute coronary syndrome patients with AAC had significantly higher 30-day mortality (17.3% vs. 7.1%, log-rank p = 0.02). During a mean follow-up period of 165 ± 140 days (maximum 492 days), the calcification group had significantly increased cardiovascular deaths (27.6% vs. 11.2%, log-rank p = 0.002), all-cause mortality (28.3% vs. 11.2%, log-rank p = 0.001) and composite endpoint of major adverse cardiovascular events (39.4% vs. 24.6%, log-rank p = 0.01). After adjusting for age, gender, diabetes mellitus and hypertension, AAC was an independent risk factor for primary and secondary endpoints among patients with acute coronary syndrome. CONCLUSIONS: AAC provided valuable prognostic information on clinical outcomes in patients with acute coronary syndrome. However, different treatment strategies would be warranted for optimal risk reduction in such a population.
BACKGROUND: To date, it remains unsettled whether aortic arch calcification (AAC) has prognostic value in patients with acute coronary syndrome. METHODS: From January 1 to December 31, 2013, a total of 225 patients with acute coronary syndrome (mean age 72 ± 26 years, 75% male) were enrolled in this study. Patients admitted to the coronary care unit of a tertiary referral medical center under the preliminary diagnosis of acute coronary syndrome were retrospectively investigated. The primary endpoint was composite of long-term major adverse cardiovascular events. The secondary endpoints were 30-day and long-term all-cause mortality. RESULTS: Of the 225 patients enrolled in this study, 143 had detectable AAC. Those who had AAC were older, with higher Killip classification and thrombolysis in myocardial infarction (TIMI) score with a lower probability of single vessel disease. Acute coronary syndromepatients with AAC had significantly higher 30-day mortality (17.3% vs. 7.1%, log-rank p = 0.02). During a mean follow-up period of 165 ± 140 days (maximum 492 days), the calcification group had significantly increased cardiovascular deaths (27.6% vs. 11.2%, log-rank p = 0.002), all-cause mortality (28.3% vs. 11.2%, log-rank p = 0.001) and composite endpoint of major adverse cardiovascular events (39.4% vs. 24.6%, log-rank p = 0.01). After adjusting for age, gender, diabetes mellitus and hypertension, AAC was an independent risk factor for primary and secondary endpoints among patients with acute coronary syndrome. CONCLUSIONS: AAC provided valuable prognostic information on clinical outcomes in patients with acute coronary syndrome. However, different treatment strategies would be warranted for optimal risk reduction in such a population.
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