Ten-year predictors of major adverse cardiovascular events in patients without angina

South African Family Practice

Field Value
Title Ten-year predictors of major adverse cardiovascular events in patients without angina
Creator Premsagar, Preesha Aldous, Colleen Esterhuizen, Tonya
Subject Family Medicine, Preventative Disease Cox model; diabetes; Indian; morbidity; mortality
Description Background: Longstanding cardiovascular risk factors cause major adverse cardiovascular events (MACE). Major adverse cardiovascular events prediction may improve outcomes. The aim was to evaluate the ten-year predictors of MACE in patients without angina.Methods: Patients referred to Inkosi Albert Luthuli Hospital, Durban, South Africa, without typical angina from 2002 to 2008 were collected and followed up for MACE from 2009 to 2019. Survival time was calculated in months. Independent variables were tested with Cox proportional hazard models to predict MACE morbidity and MACE mortality.Results: There were 525 patients; 401 (76.0%) were Indian, 167 (31.8%) had diabetes at baseline. At 10-year follow up 157/525 (29.9%) experienced MACE morbidity, of whom, 82/525 (15.6%) had MACE mortality. There were 368/525 (70.1%) patients censored, of whom 195/525 (37.1%) were lost to follow up. For MACE morbidity, mean and longest observation times were 102.2 and 201 months, respectively. Predictors for MACE morbidity were age (hazard ratio [HR] = 1.025), diabetes (HR = 1.436), Duke Risk category (HR = 1.562) and Ischaemic burden category (HR = 1.531). For MACE mortality, mean and longest observation times were 107.9 and 204 months, respectively. Predictors for MACE mortality were age (HR = 1.044), Duke Risk category (HR = 1.983), echocardiography risk category (HR = 2.537) and Ischaemic burden category (HR = 1.780).Conclusion: Among patients without typical angina, early ischaemia on noninvasive tests indicated microvascular disease and hyperglycaemia, predicting long-term MACE morbidity and MACE mortality.Contribution: Diabetes was a predictor for MACE morbidity but not for MACE mortality; patients lost to follow-up were possibly diabetic patients with MACE mortality at district hospitals. Early screening for ischaemia and hyperglycaemia control may improve outcomes.
Publisher AOSIS
Contributor Nil
Date 2023-08-04
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — Quantitative
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/safp.v65i1.5629
Source South African Family Practice; Vol 65, No 1 (2023): Part 3; 9 pages 2078-6204 2078-6190
Language eng
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:

https://safpj.co.za/index.php/safpj/article/view/5629/8179 https://safpj.co.za/index.php/safpj/article/view/5629/8180 https://safpj.co.za/index.php/safpj/article/view/5629/8181 https://safpj.co.za/index.php/safpj/article/view/5629/8182
Coverage South Africa, KwaZulu-Natal 2002-2019 Age over 18 years; Gender male and female; Ethnicity all but mostly Indian
Rights Copyright (c) 2023 Preesha Premsagar, Colleen Aldous, Tonya Esterhuizen https://creativecommons.org/licenses/by/4.0