2023 年 69 巻 4 号 p. 307-318
Objectives Despite the rapid aging of the population in Japan, clinical predictors for major adverse cerebrovascular and cardiovascular events (MACCE) in patients with new onset of acute coronary syndromes (ACS) have not been well studied. This study therefore aimed to identify the predictors of MACCE in the first onset of ACS patients requiring care.
Materials and Methods Using the Yokohama Original Medical Database, we identified 3,373 patients who experienced a first onset of ACS and had certified care information from April 2014 to March 2016. The incidence proportion of MACCE from June 2014 to March 2018 was retrospectively investigated. Each patient’s independence of daily living (IDL) was classified as one of three categories (reference, mild and severe).
Results Predictors of MACCE were identified using multivariate logistic regression analysis. Impaired IDL was associated with increased MACCE, with adjusted odds ratios for reference, mild and severe of 1.00, 1.35 (95% confidence intervals 1.14-1.60) and 2.12 (95% confidence intervals 1.61-2.80; P for trend < 0.001), respectively.
Conclusions This study revealed that male sex, chronic kidney disease, atrial fibrillation, high-intensity statin use, low-intensity statin use, and lower IDL (representing less independence) were the predictors of MACCE requiring care for a first onset of ACS. Further research will be required to understand the results of interventions for the identified predictors of MACCE.
