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- Title
Prognosis of cardiovascular and non-cardiovascular multimorbidity after acute coronary syndrome.
- Authors
Canivell, Silvia; Muller, Olivier; Gencer, Baris; Heg, Dik; Klingenberg, Roland; Räber, Lorenz; Carballo, David; Matter, Christian; Lüscher, Thomas; Windecker, Stephan; Mach, François; Rodondi, Nicolas; Nanchen, David
- Abstract
Objective: To examine the prognosis of patients with cardiovascular and non-cardiovascular multimorbidity after acute coronary syndrome compared to patients without prior multimorbidity. Methods: This multicenter prospective cohort study in Switzerland included 5,635 patients hospitalized with acute coronary syndrome between 2009 and 2014, with a one-year follow-up period. We defined cardiovascular and non-cardiovascular multimorbidity as having at least two prior comorbidities before the index hospitalization. Multivariable adjusted Cox proportional models were built to assess the one-year risk of recurrent cardiovascular events, defined as cardiovascular mortality and non-fatal myocardial infarction or stroke. The final model was adjusted for age, gender, body mass index, tobacco consumption, education, and family history of cardiovascular disease, prescription of high-dose statinsat discharge and use of cardiac rehabilitation after discharge. Results: Overall, 3,664 patients (65%) had no multimorbidity, 1,839 (33%) had cardiovascular multimorbidity, 62 (1%) had non-cardiovascular multimorbidity, and 70 (1%) had both cardiovascular and non-cardiovascular multimorbidity. The multivariate risk of recurrent cardiovascular events was increased among patients with cardiovascular multimorbidity (hazard ratio (HR) 2.05, 95% CI: 1.54–2.73, p<0.001) and patients with non-cardiovascular multimorbidity (HR 2.57, 95% CI: 1.04–6.35, p = 0.04) compared to patients without multimorbidity. Patients with cardiovascular and non-cardiovascular multimorbidity had the highest risk of recurrence with a HR of 5.19, 95% CI: 2.79–9.64, p<0.001, compared to patients without multimorbidity. Conclusions: Multimorbidity increased by two-fold the risk of cardiovascular events over the year after an acute coronary syndrome. The magnitude of this increased risk was similar for patients with cardiovascular or non-cardiovascular multimorbidity.
- Subjects
SWITZERLAND; CARDIOVASCULAR diseases; ACUTE coronary syndrome; COMORBIDITY; BODY mass index; LONGITUDINAL method; PROGNOSIS
- Publication
PLoS ONE, 2018, Vol 13, Issue 4, p1
- ISSN
1932-6203
- Publication type
Article
- DOI
10.1371/journal.pone.0195174