Bermon Anderson, Trejo-Valdivia Belem, Molina Castaño Carlos Federico, Segura Angela M, Serrano Norma C
Centro de Investigaciones, Fundación Cardiovascular de Colombia, Bucaramanga, COL.
Escuela de graduados, Universidad CES, Medellín, COL.
Cureus. 2024 Apr 30;16(4):e59366. doi: 10.7759/cureus.59366. eCollection 2024 Apr.
The prevalence of the population with a history of an occlusive cardiovascular event has been increasing in recent years, which means that a large number of patients will have a higher risk of presenting a fatal recurrence. The aim is to determine variables associated with time-to-recurrent cardiovascular events and analyze how changes in low-density lipoprotein cholesterol (LDL-C) levels during follow-up may be associated with this time-to-event.
This is a prospective observational cohort study of 727 adults with a history of at least one occlusive cardiovascular event recruited at a referral hospital in northeastern Colombia. Data from a follow-up period of a maximum of 33 months (median 26 months) (one death) were used to define how clinical and sociodemographic variables impact the recurrence of major adverse cardiovascular events (MACE). Analyses were performed based on proportional hazard models and time-dependent hazard models.
Upon enrollment, 215 (30%) of the participants reported experiencing their most recent cardiovascular event within the preceding year. After two years, the recurrence rate was 12.38% (90/727). The risk of recurrence before two years was 3.9% (95% CI 2.7-5.6). In the multiple models, the presence of severe depression gives a Hazard Ratio of 8.25 (95% CI 2.98-22.86) and LDL ≥120 md/dl Hazard Ratio of 2.12 (95% CI 1.2 -3.9). It was found that LDL >120 mg/dl maintained over time increases the chances of recurrence by 1.7% (Hazard Ratio: 1.017, 95% CI 0.008-0.025).
The present study allows us to identify a profile of patients who should be treated promptly in an interdisciplinary manner to avoid recurrences of coronary events.
近年来，有心血管闭塞事件病史的人群患病率一直在上升，这意味着大量患者出现致命复发的风险更高。目的是确定与复发性心血管事件发生时间相关的变量，并分析随访期间低密度脂蛋白胆固醇（LDL-C）水平的变化如何与该事件发生时间相关。
这是一项对哥伦比亚东北部一家转诊医院招募的727名有至少一次心血管闭塞事件病史的成年人进行的前瞻性观察队列研究。使用最长33个月（中位数26个月）（1例死亡）的随访期数据来确定临床和社会人口统计学变量如何影响主要不良心血管事件（MACE）的复发。基于比例风险模型和时间依赖性风险模型进行分析。
入组时，215名（30%）参与者报告在过去一年内经历了最近一次心血管事件。两年后，复发率为12.38%（90/727）。两年前的复发风险为3.9%（95%CI 2.7-5.6）。在多模型中，重度抑郁症的存在使风险比为8.25（95%CI 2.98-22.86），LDL≥120 md/dl使风险比为2.12（95%CI 1.2-3.9）。发现随着时间推移LDL>120 mg/dl会使复发几率增加1.7%（风险比：1.017，95%CI 0.008-0.025）。
本研究使我们能够确定应以跨学科方式及时治疗以避免冠心病事件复发的患者特征。
