Yong Huo1, Stephen W-L Lee2, Jitendra P S Sawhney3, Hyo-Soo Kim4, Rungroj Krittayaphong5, Stuart J Pocock6, Vo T Nhan7, Ángeles Alonso-Garcia8, Chee Tang Chin9, Jie Jiang10, Stephen Jan11, Ana M Vega12, Nobuya Hayashi13, Tiong Kiam Ong14. 1. Peking University First Hospital, Beijing, China. Electronic address: huoyong@263.net.cn. 2. Queen Mary Hospital, Hong Kong, China. 3. Sir Ganga Ram Hospital, New Delhi, India. 4. Seoul National University Hospital, Seoul, Republic of Korea. 5. Siriraj Hospital, Bangkok, Thailand. 6. London School of Hygiene and Tropical Medicine, London, UK. 7. Cho Ray Hospital, Ho Chi Minh City, Viet Nam. 8. Imperial College, National Health Service (NHS) Trust, London, UK. 9. National Heart Centre Singapore, Singapore. 10. Peking University First Hospital, Beijing, China. 11. The George Institute for Global Health, University of New South Wales, Sydney, Australia. 12. Medical Evidence and Observational Research, Global Medical Affairs, AstraZeneca, Madrid, Spain. 13. AstraZeneca, Osaka, Japan. 14. Sarawak General Hospital, Kuching, Malaysia.
Abstract
AIMS: Approximately half of cases of cardiovascular disease (CVD) worldwide occur in Asia, with acute coronary syndrome (ACS) a leading cause of mortality. Long-term ACS-related outcomes data in Asia are limited. This analysis examined 2-year ACS-related outcomes in patients enrolled in the EPICOR Asia study, and the association between patient characteristics and management on outcomes. METHODS: EPICOR Asia is a multinational, prospective, primary data collection study of real-world management of Asian patients with ACS. Overall, 12,922 eligible adults (hospitalized for ACS within 48 h of symptom onset and who survived to discharge) were enrolled from 219 centers in eight Asian countries. Patients were followed up post-discharge for 2 years and clinical outcomes recorded. RESULTS: Patients were of mean age 60 years and 76% were male. Diagnoses were STEMI (51.2%), NSTEMI (19.9%), and UA (28.9%). During follow-up, 5.2% of patients died; NSTEMI patients had the highest risk profile. Mortality rate (adjusted HR [95% CI]) was similar in NSTEMI (0.97 [0.81-1.17]) and lower in UA (0.52 [0.33-0.82]) vs STEMI. Similar trends (adjusted) were seen for the composite endpoint of death, myocardial infarction, or ischemic stroke, and bleeding rates did not differ significantly. For all three diagnoses, patients who were medically managed had a markedly elevated risk of both death and the composite endpoint. CONCLUSIONS: During 2-year follow-up, adjusted risks of mortality, the composite endpoint, and bleeding rates were similar in NSTEMI and STEMI patients. Outcomes risk was better for invasive management. Long-term management strategies in Asia need to be optimized.
AIMS: Approximately half of cases of cardiovascular disease (CVD) worldwide occur in Asia, with acute coronary syndrome (ACS) a leading cause of mortality. Long-term ACS-related outcomes data in Asia are limited. This analysis examined 2-year ACS-related outcomes in patients enrolled in the EPICOR Asia study, and the association between patient characteristics and management on outcomes. METHODS: EPICOR Asia is a multinational, prospective, primary data collection study of real-world management of Asian patients with ACS. Overall, 12,922 eligible adults (hospitalized for ACS within 48 h of symptom onset and who survived to discharge) were enrolled from 219 centers in eight Asian countries. Patients were followed up post-discharge for 2 years and clinical outcomes recorded. RESULTS:Patients were of mean age 60 years and 76% were male. Diagnoses were STEMI (51.2%), NSTEMI (19.9%), and UA (28.9%). During follow-up, 5.2% of patientsdied; NSTEMI patients had the highest risk profile. Mortality rate (adjusted HR [95% CI]) was similar in NSTEMI (0.97 [0.81-1.17]) and lower in UA (0.52 [0.33-0.82]) vs STEMI. Similar trends (adjusted) were seen for the composite endpoint of death, myocardial infarction, or ischemic stroke, and bleeding rates did not differ significantly. For all three diagnoses, patients who were medically managed had a markedly elevated risk of both death and the composite endpoint. CONCLUSIONS: During 2-year follow-up, adjusted risks of mortality, the composite endpoint, and bleeding rates were similar in NSTEMI and STEMI patients. Outcomes risk was better for invasive management. Long-term management strategies in Asia need to be optimized.
Authors: Yong Huo; Frans Van de Werf; Yaling Han; Xavier Rossello; Stuart J Pocock; Chee Tang Chin; Stephen W-L Lee; Yi Li; Jie Jiang; Ana Maria Vega; Jesús Medina; Héctor Bueno Journal: Am J Cardiovasc Drugs Date: 2021-02-04 Impact factor: 3.571
Authors: Bo Zheng; Yong Huo; Stephen W-L Lee; Jitendra P S Sawhney; Hyo-Soo Kim; Rungroj Krittayaphong; Stuart J Pocock; Vo T Nhan; Angeles Alonso Garcia; Chee Tang Chin; Jie Jiang; Stephen Jan; Ana Maria Vega; Nobuya Hayashi; Tiong K Ong Journal: Clin Cardiol Date: 2020-07-02 Impact factor: 2.882