title: The burden of major adverse cardiac events in patients with coronary artery disease.
abstract: Patients with a history of cardiovascular disease are at high risk of developing secondary major adverse cardiac events (MACE). This study aimed to identify independent predictors of MACE after hospital admission which could be used to identify of high-risk patients who may benefit from preventive strategies.
  
  
  
  This study included 1,520 consecutive patients with coronary artery disease (CAD) (654 with acute coronary syndrome (ACS) and 866 with elective percutaneous coronary intervention (PCI) patients) who received PCI and/or stenting. MACE was defined as all-cause mortality or rehospitalization for a cardiovascular- related illness. Cardiovascular-related illnesses included heart failure, reinfarction (nonfatal), recurrence of angina pectoris and repeat PCI or coronary artery bypass graft.
  
  
  
  During a mean follow-up period of 32 months, 558 of the 1,520 patients developed at least one MACE. Cox regression analysis showed that the baseline clinical and biochemical variables which associated with MACE were age, being illiterate, a widow or widower, and/or economically dependent, having triple vessel disease, stent implantation, anemia, and/or diabetes mellitus, waist to hip ratio (WHR), diastolic blood pressure, fasting glucose, total cholesterol, high-density lipoprotein cholesterol (HDL-C), creatinine, estimated glomerular filtration rate (eGFR), red blood cell count, hemoglobin, hematocrit, and mean corpuscular-hemoglobin concentration (MCHC) in ACS patients, and age, malnourished, and/or economically dependent, taking hypoglycemic medication, having triple vessel disease, stent implantation, anemia, diabetes mellitus, and/or hypertension, WHR, fasting glucose, HDL-C, uric acid, creatinine, eGFR, high-sensitivity C-reactive protein, mean corpuscular volume, and MCHC in elective PCI patients. Using multivariate Cox regression analysis, we found the MACE's independent factors are triple vessel disease, stent implantation, hypertension, and eGFR in ACS patients, and having triple vessel disease, stent implantation, hypertension, and uric acid in elective PCI patients.
  
  
  
  Having triple vessel disease, stent implantation, hypertension, and eGFR or uric acid independently predicted MACE in patients with CAD after long-term follow-up. Fortunately, these factors are modifiable and should be identified and monitored early.
authors.affiliation: Department of Emergency, E-Da Hospital, I-Shou University, Kaohsiung, 82445, Taiwan.|Department of Nursing, I-Shou University, Kaohsiung, 82445, Taiwan.
authors.forename: I-Ting
authors.initials: IT
authors.lastname: Tsai
authors.affiliation: Division of Cardiology, E-Da Hospital, I-Shou University, No. 1, Yi-Da Rd, Jiau-Shu Village, Yan-Chao District, Kaohsiung, 82445, Taiwan.|School of Medicine for International Students, E-Da Hospital, I-Shou University, Kaohsiung, 82445, Taiwan.
authors.forename: Chao-Ping
authors.initials: CP
authors.lastname: Wang
authors.affiliation: Division of Endocrinology and Metabolism, E-Da Hospital, I-Shou University, Kaohsiung, 82445, Taiwan.|School of Medicine for International Students, E-Da Hospital, I-Shou University, Kaohsiung, 82445, Taiwan.
authors.forename: Yung-Chuan
authors.initials: YC
authors.lastname: Lu
authors.affiliation: Division of Cardiology, E-Da Hospital, I-Shou University, No. 1, Yi-Da Rd, Jiau-Shu Village, Yan-Chao District, Kaohsiung, 82445, Taiwan.
authors.forename: Wei-Chin
authors.initials: WC
authors.lastname: Hung
authors.affiliation: Division of Cardiology, E-Da Hospital, I-Shou University, No. 1, Yi-Da Rd, Jiau-Shu Village, Yan-Chao District, Kaohsiung, 82445, Taiwan.|Department of Biomedical Engineering, National Cheng Kung University, Tainan, 70101, Taiwan.
authors.forename: Cheng-Ching
authors.initials: CC
authors.lastname: Wu
authors.affiliation: Division of Cardiac Surgery, Department of Surgery, E-Da Hospital, I-Shou University, Kaohsiung, 82445, Taiwan.
authors.forename: Li-Fen
authors.initials: LF
authors.lastname: Lu
authors.affiliation: Division of Cardiology, E-Da Hospital, I-Shou University, No. 1, Yi-Da Rd, Jiau-Shu Village, Yan-Chao District, Kaohsiung, 82445, Taiwan.
authors.forename: Fu-Mei
authors.initials: FM
authors.lastname: Chung
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, 82445, Taiwan.
authors.forename: Chia-Chang
authors.initials: CC
authors.lastname: Hsu
authors.affiliation: Lee's Endocrinology Clinic, Pingtung, 90000, Taiwan.
authors.forename: Yau-Jiunn
authors.initials: YJ
authors.lastname: Lee
authors.affiliation: Division of Cardiology, E-Da Hospital, I-Shou University, No. 1, Yi-Da Rd, Jiau-Shu Village, Yan-Chao District, Kaohsiung, 82445, Taiwan. gene6623@yahoo.com.tw.
authors.forename: Teng-Hung
authors.initials: TH
authors.lastname: Yu
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D016009:Chi-Square Distribution; D015897:Comorbidity; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D005260:Female; D005919:Glomerular Filtration Rate; D006760:Hospitalization; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D033461:Hyperuricemia / Q000097:blood / Q000453:epidemiology; D007668:Kidney / Q000503:physiopathology; D007674:Kidney Diseases / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012372:ROC Curve; D012008:Recurrence; D019233:Retreatment; D018570:Risk Assessment; D012307:Risk Factors; D012959:Socioeconomic Factors; D015607:Stents; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome; D014527:Uric Acid / Q000097:blood
chemical_list: D014527:Uric Acid
keywords: Coronary artery disease; Major adverse cardiovascular events; Predictive factors