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Non-stenotic fibro-calcific aortic valve as a predictor of myocardial infarction recurrence.
Myasoedova, Veronika A; Chiesa, Mattia; Cosentino, Nicola; Bonomi, Alice; Ludergnani, Monica; Bozzi, Michele; Valerio, Vincenza; Moschetta, Donato; Massaiu, Ilaria; Mantegazza, Valentina; Marenzi, Giancarlo; Poggio, Paolo.
Afiliación
  • Myasoedova VA; Centro Cardiologico Monzino, IRCCS, Milan  Italy.
  • Chiesa M; Centro Cardiologico Monzino, IRCCS, Milan  Italy.
  • Cosentino N; Department of Electronics, Information and Biomedical engineering, Politecnico di Milano, Milan, Italy.
  • Bonomi A; Centro Cardiologico Monzino, IRCCS, Milan  Italy.
  • Ludergnani M; Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy.
  • Bozzi M; Centro Cardiologico Monzino, IRCCS, Milan  Italy.
  • Valerio V; Centro Cardiologico Monzino, IRCCS, Milan  Italy.
  • Moschetta D; Centro Cardiologico Monzino, IRCCS, Milan  Italy.
  • Massaiu I; Centro Cardiologico Monzino, IRCCS, Milan  Italy.
  • Mantegazza V; Centro Cardiologico Monzino, IRCCS, Milan  Italy.
  • Marenzi G; Centro Cardiologico Monzino, IRCCS, Milan  Italy.
  • Poggio P; Centro Cardiologico Monzino, IRCCS, Milan  Italy.
Eur J Prev Cardiol ; 2024 02 14.
Article en En | MEDLINE | ID: mdl-38365224
ABSTRACT

BACKGROUND:

Patients with acute myocardial infarction (AMI) are at increased risk of recurrent cardiovascular events. Non-stenotic aortic valve fibro-calcific remodeling (AVSc), reflecting systemic damage, may serve as a new marker of risk.

OBJECTIVES:

To stratify subgroups of AMI patients with specific probabilities of recurrent AMI and to evaluate the importance of AVSc in this setting.

METHODS:

Consecutive AMI patients (n = 2530) were admitted at Centro Cardiologico Monzino (2010-2019) and followed up for 5 years. Patients were divided into study (n = 1070) and test (n = 966) cohorts. Topological data analysis (TDA) was used to stratify patient subgroups, while Kaplan-Meier and Cox regressions analyses were used to evaluate the significance of baseline characteristics.

RESULTS:

TDA identified 11 subgroups of AMI patients with specific baseline characteristics. Two subgroups showed the highest rate of reinfarction after 5 years from the indexed AMI with a combined hazard ratio (HR) of 3.8 (95%CI 2.7-5.4) compared to the other subgroups. This was confirmed in the test cohort (HR = 3.1; 95%CI 2.2-4.3). These two subgroups were mostly men, with hypertension and dyslipidemia, who exhibit higher prevalence of AVSc, higher levels of high-sensitive c-reactive protein and creatinine. In the year-by-year analysis, AVSc, adjusted for all confounders, showed an independent association with the increased risk of reinfarction (odds ratio of ∼2 at all time-points), in both the study and the test cohorts (all p < 0.01).

CONCLUSIONS:

AVSc is a crucial variable for identifying AMI patients at high risk of recurrent AMI and its presence should be considered when assessing the management of AMI patients. The inclusion of AVSc in risk stratification models may improve the accuracy of predicting the likelihood of recurrent AMI, leading to more personalized treatment decisions.
We wanted to understand the factors that make some acute myocardial infarction (AMI) patients more likely to experience recurrent infarction after leaving the hospital. Specifically, we asked whether a heart valve condition called non-stenotic aortic valve fibro-calcific remodeling (AVSc) could be a crucial factor. Our study used advanced data analysis techniques, including topological data analysis (TDA), to explore this question. We unveil that AVSc is indeed a significant predictor of recurrent infarction in AMI patients. Our findings suggest that the presence of aortic valve remodeling should be taken into account when assessing the risk of recurrent AMI and managing these patients.
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Texto completo: 1 Base de datos: MEDLINE Idioma: En Revista: Eur J Prev Cardiol Año: 2024 Tipo del documento: Article

Texto completo: 1 Base de datos: MEDLINE Idioma: En Revista: Eur J Prev Cardiol Año: 2024 Tipo del documento: Article