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American Journal of Cardiology, 2019. 124, 857-863, DOI: https://doi.org/10.1016/j.amjcard.2019.06.010
Usefulness of Calculation of Cardiovascular Risk Factors to Predict Outcomes in Patients With Acute Myocardial Infarction
Chang-Yeon Kim, Jang Hoon Lee; Se Yong Jang; Myung Hwan Bae; Dong Heon Yang; Hun Sik Park; Yongkeun Cho; Myung Ho Jeong; Jong-Seon Park; Hyo-Soo Kim; Seung-Ho Hur; In-Whan Seong; Myeong-Chan Cho; Chong-Jin Kim; Shung Chull Chae
Cardiovascular risk factors contribute differently to short-term prognosis of acute myocardial infarction (AMI); hypertension and diabetes increase adverse outcomes, whereas hyperlipidemia, smoking, and obesity seem to paradoxically decrease these in post-MI patients. We aimed to investigate whether a simple calculation of conventional risk factors, PARADOCS (Pressure of ARtery elevAtion, Diabetes, Obesity, Cholesterol, Smoking) score, would improve the ability to predict major adverse cardiac and cerebrovascular events (MACCEs) in post-MI patients. Between November 2011 and December 2015, 13,104 patients with diagnosis of AMI were analyzed in this study from Korean AMI Registry – National Institute of Health database. PARADOCS score was calculated as follows: (number of nonparadoxical risk factors − number of paradoxical risk factors) + 3 where nonparadoxical risk factors are hypertension and diabetes, and paradoxical risk factors are hyperlipidemia, smoking, and obesity. PARADOCS score was significantly greater in patients with 1-year MACCEs compared with those without MACCEs (3.43 ± 1.03 vs 2.88 ± 1.11, p <0.001). In Cox proportional hazards model, PARADOCS score was an independent predictor of 1-year MACCEs (hazards ratio 1.23, 95% confidence interval 1.16 to 1.30; p <0.001) after adjusting for confounding variables. In Kaplan-Meier survival curve, patients with greater PARADOCS score had worse clinical outcome. In conclusion, although it needs more validation, a simple calculation of risk factors, PARADOCS score, could provide useful prognostic information of MI patients to clinicians.
- DOI: https://doi.org/10.1016/j.amjcard.2019.06.010
- ISBN or ISSN: 0002-9149
- 본 연구는 질병관리본부 연구개발과제연구비를 지원받아 수행되었습니다.
- This research was supported by a fund by Research of Korea Centers for Disease Control and Prevention.