Comparisons of Patients Living Alone versus Living with Others in Acute Coronary Syndrome.

IF 0.5 Q4 PERIPHERAL VASCULAR DISEASE International Journal of Angiology Pub Date : 2023-04-12 eCollection Date: 2023-09-01 DOI:10.1055/s-0043-1767697
Yusaku Shibata, Nobuaki Kobayashi, Akihiro Shirakabe, Yasushi Miyauchi, Kuniya Asai
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Abstract

We aimed to examine the relationship of living arrangements (i.e., living alone or living with others) with background, clinical severity, preintervention culprit lesion plaque morphology, and clinical outcomes in patients with acute coronary syndrome (ACS). Among 1,683 consecutive patients with ACS, we retrospectively compared patients living alone ( n  = 318) versus living with others ( n  = 1,362). Optical coherence tomography (OCT) findings, which are high-resolution intracoronary imaging devices, were analyzed in patients with preintervention OCT and compared between patients living alone ( n  = 174) versus those living with others ( n  = 665). Older (median; 69 vs. 67 y, p  = 0.046) and female (31 vs. 17%, p  < 0.001) patients more frequently lived alone. Frequency of achieving a time interval of 6 hours or less from ACS onset to admission was lower in patients living alone (56 vs. 63%, p  = 0.022). Clinical presentation was more severe in patients living alone (Killip II/III/IV; 27 vs. 22%, p  = 0.029). Plaque morphology evaluated by OCT was similar between groups (plaque rapture; 48 vs. 48%, p  = 0.171). Kaplan-Meier analyses revealed higher rates of cardiac mortality during 2-year follow-up period in patients living alone [13.9 vs. 8.5%, hazard ratio (HR) 1.604, 95% confidence interval (CI) 1.112-2.313, p  = 0.010]. After traditional cardiovascular risk factors and clinical severity upon admission had been adjusted, living alone was an independent predictor of cardiac mortality in ACS patients (HR 1.582, 95% CI 1.056-2.371, p  = 0.026). Living alone was independently associated with 2-year cardiacmortality in ACS patients after adjusting for background and presentation and might be unrelated to the development of atherosclerosis.

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急性冠状动脉综合征患者独居与与他人同住的比较。
我们的目的是研究急性冠状动脉综合征(ACS)患者的居住安排(即独居或与他人同住)与背景、临床严重程度、干预前罪魁祸首病变斑块形态和临床预后之间的关系。在 1683 名连续的 ACS 患者中,我们对独居患者(n = 318)和与他人同住患者(n = 1362)进行了回顾性比较。光学相干断层扫描(OCT)是一种高分辨率冠状动脉内成像设备,我们分析了患者干预前的 OCT 结果,并比较了独居患者(n = 174)与同住患者(n = 665)之间的差异。患者年龄较大(中位数;69 岁对 67 岁,P = 0.046),女性(31% 对 17%,P = 0.022)。独居患者的临床表现更为严重(Killip II/III/IV; 27 vs. 22%, p = 0.029)。通过 OCT 评估的斑块形态在各组之间相似(斑块突变;48 vs. 48%,p = 0.171)。卡普兰-梅耶分析显示,独居患者在两年随访期间的心脏死亡率更高[13.9% 对 8.5%,危险比 (HR) 1.604,95% 置信区间 (CI) 1.112-2.313, p = 0.010]。在对传统的心血管风险因素和入院时的临床严重程度进行调整后,独居是 ACS 患者心脏病死亡率的独立预测因素(HR 1.582,95% 置信区间 (CI) 1.056-2.371,p = 0.026)。在对背景和表现进行调整后,独居与 ACS 患者的 2 年心脏死亡率有独立关联,可能与动脉粥样硬化的发展无关。
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来源期刊
International Journal of Angiology
International Journal of Angiology PERIPHERAL VASCULAR DISEASE-
CiteScore
1.30
自引率
16.70%
发文量
57
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