Assessing Risk in Patients with Stable Coronary Disease: When Should We Intensify Care and Follow-Up? Results from a Meta-Analysis of Observational Studies of the COURAGE and FAME Era
| Autor: | Claudio Moretti, Marco G. Mennuni, Davide Capodanno, Michael J. Lipinski, Umberto Barbero, Marco Francesco Lococo, Giuseppe Biondi-Zoccai, Fiorenzo Gaita, Fabrizio D'Ascenzo, Freek Nijhoff |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Agricultural and Biological Sciences (all) medicine.medical_treatment MEDLINE lcsh:Medicine Review Article Revascularization Coronary artery disease Internal medicine medicine Clinical endpoint Myocardial infarction lcsh:Science General Environmental Science business.industry lcsh:R medicine.disease Meta-analysis Physical therapy Observational study lcsh:Q General Agricultural and Biological Sciences business Mace |
| Zdroj: | Scientifica, Vol 2016 (2016) Scientifica |
| Popis: | Background. A large number of clinical and laboratory markers have been appraised to predict prognosis in patients with stable angina, but uncertainty remains regarding which variables are the best predictors of prognosis. Therefore, we performed a meta-analysis of studies in patients with stable angina to assess which variables predict prognosis.Methods. MEDLINE and PubMed were searched for eligible studies published up to 2015, reporting multivariate predictors of major adverse cardiac events (MACE, a composite endpoint of death, myocardial infarction, and revascularization) in patients with stable angina. Study features, patient characteristics, and prevalence and predictors of such events were abstracted and pooled with random-effect methods (95% CIs). Major adverse cardiovascular event (MACE) was the primary endpoint.Results. 42 studies (104,559 patients) were included. After a median follow-up of 57 months, cardiovascular events occurred in 7.8% of patients with MI in 6.2% of patients and need for repeat revascularization (both surgical and percutaneous) in 19.5% of patients. Male sex, reduced EF, diabetes, prior MI, and high C-reactive protein were the most powerful predictors of cardiovascular events.Conclusions. We show that simple and low-cost clinical features may help clinicians in identifying the most appropriate diagnostic and therapeutic approaches within the broad range of outpatients presenting with stable coronary artery disease. |
| Databáze: | OpenAIRE |
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