Introduction
Methods
Study population
Data collection
Outcomes
Statistical analysis
Results
Baseline characteristics
Variable | Overall (n = 330) | MACEs (n = 68) | Non-MACEs (n = 262) | P-Value | Death (n = 44) | Survival (n = 286) | P-Value |
---|---|---|---|---|---|---|---|
Age (years) | 80.0 (77.0, 83.0) | 81.0 (78.0, 84.0) | 80.0 (77.0, 83.0) | 0.193 | 81.0 (79.0, 83.0) | 80.0 (77.0, 83.0) | 0.162 |
≥ 80 (n, %) | 180 (54.5) | 40 (58.9) | 140 (54.2) | 0.427 | 28 (63.6) | 152 (53.1) | 0.193 |
Male (n, %) | 217 (65.8) | 47 (69.2) | 170 (64.8) | 0.512 | 30 (68.2) | 187 (65.4) | 0.716 |
Medical history (n, %) | |||||||
Hypertension | 223 (67.6) | 48 (70.6) | 175 (66.8) | 0.551 | 31 (70.5) | 192 (67.1) | 0.661 |
Diabetes | 100 (30.3) | 25 (36.8) | 75 (28.6) | 0.193 | 15 (34.1) | 85 (29.7) | 0.557 |
Prior MI | 46 (13.9) | 11 (16.2) | 35 (13.4) | 0.550 | 8 (18.2) | 38 (13.3) | 0.383 |
Prior PCI or CABG | 49 (14.8) | 10 (14.7) | 39 (14.9) | 0.970 | 6 (13.6) | 43 (15.0) | 0.808 |
Prior stroke | 45 (13.6) | 8 (11.8) | 37 (14.1) | 0.614 | 3 (6.8) | 42 (14.7) | 0.157 |
Medication history (n, %) | |||||||
Diuretics | 57 (17.2) | 21 (30.9) | 36 (13.7) | 0.001* | 17 (38.6) | 40 (14.0) | < 0.001* |
Dapagliflozin | 11 (3.3) | 1 (1.5) | 10 (3.8) | 0.561 | 0 (0) | 11 (3.8) | 0.371 |
Allopurinol | 5 (1.5) | 2 (2.9) | 3 (1.1) | 0.601 | 2 (4.5) | 3 (1.0) | 0.269 |
Febuxostat | 4 (1.2) | 1 (1.5) | 3 (1.1) | 1.000 | 0 (0) | 4 (1.4) | 1.000 |
ARB | 70 (21.2) | 21 (30.9) | 49 (18.7) | 0.029* | 13 (29.5) | 57 (19.9) | 0.146 |
Cardiac arrest before admission | 23 (7.0) | 5 (7.4) | 18 (6.9) | 0.889 | 4 (9.1) | 19 (6.6) | 0.553 |
Current smoking | 59 (17.9) | 10 (14.7) | 49 (18.7) | 0.443 | 5 (11.4) | 54 (18.9) | 0.226 |
Clinical characteristics (n, %) | |||||||
STEMI | 235 (71.2) | 51 (75.0) | 184 (70.2) | 0.439 | 32 (72.7) | 203 (71.0) | 0.812 |
TIMI risk score | 4.0 (3.0, 6.0) | 5.0 (4.0, 7.8) | 4.0 (3.0, 5.0) | < 0.001* | 5.5 (4.0, 8.0) | 4.0 (3.0, 5.0) | < 0.001* |
Revascularization details (n, %) | |||||||
Multi-vessel disease | 238 (72.1) | 49 (72.1) | 189 (72.1) | 0.990 | 31 (70.5) | 207 (72.4) | 0.791 |
Symptom-onset-to-balloon time within 12 h | 170 (51.5) | 27 (39.7) | 143 (54.6) | 0.029* | 16 (36.4) | 154 (53.8) | 0.031* |
PCI or not | 291 (88.2) | 52 (76.5) | 239 (91.2) | 0.001* | 33 (75.0) | 258 (90.2) | 0.004* |
Complete revascularization | 208 (63.0) | 39 (57.4) | 169 (64.5) | 0.276 | 25 (56.8) | 183 (64.0) | 0.359 |
Medication during hospitalization (n, %) | |||||||
Diuretics | 186 (55.8) | 49 (72.1) | 137 (52.3) | 0.002* | 33 (75.0) | 153 (53.5) | 0.006* |
Dapagliflozin | 3 (0.9) | 1 (1.5) | 2 (7.6) | 1.000 | 1 (2.3) | 2 (0.7) | 0.865 |
Allopurinol | 1 (0.3) | 0 (0) | 1 (3.8) | 1.000 | 0 (0) | 1 (0.3) | 1.000 |
Febuxostat | 1 (0.3) | 1 (1.5) | 0 (0) | 0.467 | 0 (0) | 1 (0.3) | 1.000 |
ARB | 40 (12.1) | 12 (17.6) | 28 (10.7) | < 0.001* | 8 (18.2) | 32 (11.2) | 0.186 |
Dual anti-platelet therapy | 330 (100) | 68 (100) | 262 (100) | 1.000 | 44 (100) | 286 (100) | 1.000 |
Statins | 328 (99.4) | 67 (98.5) | 261 (99.6) | 0.212 | 43 (97.7) | 285 (99.7) | 0.626 |
Biochemical variables | |||||||
Peak CK-MB | 138.5 (60.4, 276.4) | 172.5 (61.7, 307.7) | 134.0 (59.9, 270.1) | 0.229 | 200.3 (77.3, 341.7) | 132.6 (58.6, 270.0) | 0.063 |
Hemoglobin (g/L) | 127.0 (113.0, 137.0) | 122.0 (104.3, 136.8) | 127.5 (115.0, 138.0) | 0.117 | 124.0 (103.3, 135.9) | 127.0 (114.4, 138.0) | 0.305 |
Total bilirubin (mmol/L) | 14.9 (10.8, 19.8) | 17.6 (12.0,21.9) | 14.7 (10.7, 18.6) | 0.068 | 17.9 (12.2, 21.9) | 14.8 (10.7,19.2) | 0.077 |
Total cholesterol (mmol/L) | 4.5 (3.8, 5.2) | 4.2 (3.7, 5.1) | 4.5 (3.9, 5.2) | 0.112 | 4.2 (3.6, 5.2) | 4.5 (3.9, 5.2) | 0.076 |
HDL-c (mmol/L) | 1.0 (0.9, 1.2) | 1.0 (0.9, 1.3) | 1.0 (0.9, 1.2) | 0.907 | 1.1 (0.9, 1.3) | 1.0 (0.9, 1.2) | 0.223 |
LDL-c (mmol/L) | 2.8 (2.3, 3.4) | 2.6 (2.1, 3.1) | 2.9 (2.4, 3.5) | 0.008* | 2.5 (2.0, 2.9) | 2.9 (2.4, 3.5) | 0.005* |
Uric acid (µmol/L) | 419.1 (342.8, 515.1) | 419.1 (360.5, 555.8) | 419.5 (341.8, 504.9) | 0.337 | 414.1 (377.1, 551.0) | 419.1 (341.5, 512.0) | 0.307 |
Creatinine (µmol/L) | 98.0 (78.0, 126.9) | 122.3 (98.1, 147.8) | 92.6 (75.8, 121.0) | < 0.001* | 125.9 (98.5, 149.5) | 94.0 (76.1, 123.0) | < 0.001* |
SUA/Scr | 4.2 (3.0, 5.8) | 3.5 (2.6, 4.8) | 4.5 (3.2, 5.9) | 0.001* | 3.4 (2.6, 4.9) | 4.4 (3.1, 5.9) | 0.016* |
NT-pro BNP (pg/ml) | 4202.5 (1680.5, 8605.0) | 4455.5 (2905.5, 9025.3) | 4069.0 (1468.3, 8443.5) | 0.078 | 4175.5 (2820.3, 8618.8) | 4200.0 (1535.0, 8595.0) | 0.327 |
LVEF (%) | 47.0 (38.0, 58.0) | 38.0 (33.0, 47.8) | 49.0 (40.0, 59.3) | < 0.001* | 37.5 (32.0, 46.0) | 48.0 (40.0, 59.0) | < 0.001* |
ROC analysis
In-hospital outcomes | Low SUA/Scr < 3.45(n = 112) | high SUA/Scr ≧ 3.45 (n = 218) | P-Value |
---|---|---|---|
MACEs | 34 (30.4%) | 34 (15.6%) | 0.002* |
All-cause death | 23 (20.5%) | 21 (9.6%) | 0.006* |
Mechanical complications of MI | 6 (5.4%) | 6 (2.8%) | |
Rupture of the ventricular free wall | 2 | 4 | |
Rupture of the papillary muscle | 1 | 2 | |
Ventricular septal rupture | 3 | 0 | |
Cardiogenic shock | 6 | 7 | |
Malignant arrhythmia | 5 | 4 | |
Pericardial tamponade | 2 | 2 | |
Mesenteric embolism | 0 | 1 | |
Pulmonary embolism | 1 | 0 | |
Major bleeding | 1 | 0 | |
Infectious shock | 2 | 1 | |
Cardiogenic shock | 9 (8.0%) | 6 (2.8%) | |
Reinfarction | 0 (0) | 1 (0.5%) | |
Major bleeding | 2 (1.8%) | 6 (2.8%) | |
Cardiac tamponade | 0 | 0 | |
Gastrointestinal bleeding | 1 | 5 | |
Access site bleeding | 1 | 1 |
Logistic regression analysis
Variable | Univariate analysis | Multivariate analysis a | ||
---|---|---|---|---|
Odd ratios (95%CI) | P-Value | Odd ratios (95% CI) | P-Value | |
Age | 1.042 (0.978–1.109) | 0.201 | ||
Male | 1.211 (0.683–2.149) | 0.513 | ||
Hypertension | 1.193 (0.667–2.134) | 0.552 | ||
Diabetes | 1.450 (0.827–2.540) | 0.195 | ||
Smoking status | 0.749 (0.358–1.570) | 0.445 | ||
Multi-vessel disease | 0.996 (0.550–1.805) | 0.990 | ||
Complete revascularization | 0.740 (0.430–1.274) | 0.277 | ||
History of diuretics | 2.805 (1.504–5.231) | 0.001* | ||
History of ARB | 1.942 (1.065–3.542) | 0.030* | ||
Diuretics during hospitalization | 2.353 (1.314–4.213) | 0.004* | ||
ARB during hospitalization | 1.791 (0.857–3.740) | 0.121 | ||
Symptom-onset-to-balloon time within 12 h | 0.548 (0.318–0.943) | 0.030* | ||
PCI | 0.313 (0.155–0.633) | 0.001* | 0.306 (0.139–0.673) | 0.003* |
STEMI or NSTEMI | 1.272 (0.691–2.339) | 0.439 | ||
LVEF | 0.942 (0.920–0.966) | < 0.001* | 0.946 (0.922–0.971) | < 0.001* |
TIMI risk score | 1.461 (1.262–1.691) | < 0.001* | 1.453 (1.242–1.701) | < 0.001* |
LDL-c | 0.670 (0.473–0.947) | 0.023* | ||
SUA/Scr < 3.45 | 2.359 (1.369–4.065) | 0.002* | 2.144 (1.169–3.934) | 0.014* |
Variable | Univariate analysis | Multivariate analysis a | ||
---|---|---|---|---|
Odd ratios (95% CI) | P-Value | Odd ratios (95% CI) | P-Value | |
Age | 1.046 (0.971–1.126) | 0.237 | ||
Male | 1.134 (0.575–2.238) | 0.716 | ||
Hypertension | 1.167 (0.584–2.335) | 0.661 | ||
Diabetes | 1.223 (0.624–2.397) | 0.557 | ||
Smoking status | 0.551 (0.207–1.463) | 0.232 | ||
Multi-vessel disease | 0.910 (0.453–1.828) | 0.791 | ||
History of diuretics | 3.872 (1.937–7.741) | < 0.001* | ||
History of ARB | 1.685 (0.829–3.426) | 0.150 | ||
Diuretics during hospitalization | 2.682 (1.305–5.515) | 0.007* | ||
ARB during hospitalization | 1.764 (0.754–4.126) | 0.191 | ||
Symptom-onset-to-balloon time witin12hours | 0.490 (0.254–0.945) | 0.033* | ||
Complete revascularization | 0.741 (0.389–1.409) | 0.360 | ||
PCI | 0.326 (0.148–0.714) | 0.005* | 0.320 (0.134–0.765) | 0.010* |
STEMI | 1.090 (0.536–2.220) | 0.812 | ||
LVEF | 0.933 (0.906–0.962) | < 0.001* | 0.937 (0.909–0.967) | < 0.001* |
TIMI risk score | 1.442 (1.221–1.702) | < 0.001* | 1.437 (1.200–1.720) | < 0.001* |
LDL-c | 0.573 (0.372–0.884) | 0.012* | ||
SUA/Scr < 3.45 | 2.424 (1.275–4.608) | 0.007* | 2.125 (1.050–4.302) | 0.036* |
The results of subgroup analysis
Subgroup | SUA/Scr < 3.45 | SUA/Scr \(\underline{\underline > }\) 3.45 | Univariate analysis | Multivariate analysis a | ||||
---|---|---|---|---|---|---|---|---|
(No. of events/patients) | Odd ratios (95% CI) | P-value | P for interaction | Odd ratios (95% CI) | P-value | P for interaction | ||
MACEs | ||||||||
Male | 25/81 | 22/136 | 2.313 (1.200-4.459) | 0.012* | 0.959 | 2.511 (1.211–5.207) | 0.013b | 0.208 |
Female | 9/31 | 12/82 | 2.386 (0.888–6.410) | 0.084 | ||||
Deaths | ||||||||
Male | 17/81 | 13/136 | 2.513 (1.149–5.498) | 0.021* | 0.861 | 2.730 (1.146–6.502) | 0.023b | 0.165 |
Female | 6/31 | 8/82 | 2.220 (0.702–7.022) | 0.175 |