PCV8 - One-Year Clinical Outcomes In Patients With Acute Coronary Syndrome In Tianjin, China

Abstract

To evaluate the one-year clinical outcomes and identify its associated factors in patients with acute coronary syndromes (ACS) in Tianjin, China. Data were obtained from Tianjin Urban Employee Basic Medical Insurance database (2011-2015). Adult patients who were discharged alive after the first ACS-related hospitalization (index hospitalization) during 2012.01.01-2014.12.31 and had continuous enrollment during 12-month pre- (baseline) and 12-month post- (follow-up) index hospitalization were included. Clinical outcomes were measured by subsequent major adverse cardiovascular events (MACE) including hospitalization for myocardial infarction (MI) or stroke, all-cause mortality, or their composite endpoint. Cox model was used to explore the factors associated with MACE. 22,041 patients (64.7±10.7 years; 54.4% male) were identified. 9.5% (N=2,099) experienced MACE during follow-up with a mean number of 1.3±0.8. 3.1% (N=680) had MI, 5.7% (N=1,253) had stroke and 1.4% (N=298) had all-cause death. Among patients who experienced MACE, average time from index discharge to the 1st MACE was 143.2±118.8 days, and 42.1% (N=883) experienced MACE within 90 days after discharge. Being older (age 55-64: Hazard Ratio [95% CI]=1.28 [1.06-1.54]; age 65-74: HR=1.57 [1.27-1.92]; age ≥75: HR=1.91 [1.56-2.35], respectively, vs. age ≤54), male (HR=1.47 [1.34-1.61] vs. female) or patients who had higher Charlson Comorbidity Index (CCI) (HR=1.09 [1.05-1.14]) were more likely to experience MACE. Patients who had prior stroke (HR=1.77 [1.59-1.96]) and prior all-cause hospitalization (HR=1.36 [1.22-1.53]) were more likely to experience MACE, whereas prior angina (HR=0.81 [0.72-0.90]), prior β-blockers utilization (HR=0.82 [0.75-0.91]) and received percutaneous coronary intervention (PCI) during index event (HR=0.73 [0.64-0.82]) were less likely to experience MACE. Stroke is the most common type of MACE among ACS patients in Tianjin. Almost half of the 1st MACE occur within the 3 months after ACS. Patients older, male, having higher CCI and with prior stroke are at higher risk of MACE.