University of Oulu

Marjo Okkonen, Aki S. Havulinna, Olavi Ukkola, Heikki Huikuri, Arto Pietilä, Heli Koukkunen, Seppo Lehto, Juha Mustonen, Matti Ketonen, Juhani Airaksinen, Y. Antero Kesäniemi & Veikko Salomaa (2021) Risk factors for major adverse cardiovascular events after the first acute coronary syndrome, Annals of Medicine, 53:1, 817-823, DOI: 10.1080/07853890.2021.1924395

Risk factors for major adverse cardiovascular events after the first acute coronary syndrome

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Author: Okkonen, Marjo1,2; Havulinna, Aki S.3,4; Ukkola, Olavi1,2;
Organizations: 1Research Unit of Internal Medicine, University of Oulu, Oulu, Finland
2Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
3Finnish Institute for Health and Welfare, Helsinki, Finland
4FIMM: Institute for Molecular Medicine Finland, Helsinki, Finland
5Kuopio University Hospital, Kuopio, Finland;
6University of Eastern Finland, Kuopio, Finland
7North Karelia Central Hospital, Joensuu, Finland
8University of Turku and Heart Center Turku University Hospital, Turku, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.4 MB)
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Language: English
Published: Informa, 2021
Publish Date: 2021-09-03


Aims: To evaluate risk factors for major adverse cardiac event (MACE) after the first acute coronary syndrome (ACS) and to examine the prevalence of risk factors in post-ACS patients.

Methods: We used Finnish population-based myocardial infarction register, FINAMI, data from years 1993–2011 to identify survivors of first ACS (n = 12686), who were then followed up for recurrent events and all-cause mortality for three years. Finnish FINRISK risk factor surveys were used to determine the prevalence of risk factors (smoking, hyperlipidaemia, diabetes and blood pressure) in post-ACS patients (n = 199).

Results: Of the first ACS survivors, 48.4% had MACE within three years of their primary event, 17.0% were fatal. Diabetes (p = 4.4 × 10−7), heart failure (HF) during the first ACS attack hospitalization (p = 6.8 × 10−15), higher Charlson index (p = 1.56 × 10−19) and older age (p = .026) were associated with elevated risk for MACE in the three-year follow-up, and revascularization (p = .0036) was associated with reduced risk. Risk factor analyses showed that 23% of ACS survivors continued smoking and cholesterol levels were still high (>5mmol/l) in 24% although 86% of the patients were taking lipid lowering medication.

Conclusion: Diabetes, higher Charlson index and HF are the most important risk factors of MACE after the first ACS. Cardiovascular risk factor levels were still high among survivors of first ACS.

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Series: Annals of medicine
ISSN: 0785-3890
ISSN-E: 1365-2060
ISSN-L: 0785-3890
Volume: 53
Issue: 1
Pages: 817 - 823
DOI: 10.1080/07853890.2021.1924395
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Funding: FINAMI study was supported by the Finnish Foundation for Cardiovascular Research. MO has received funding from the Medical Research Centre of Oulu Doctoral Program and State Research Funding. VS has received funding from the Finnish Foundation for Cardiovascular Research.
Copyright information: © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.