Abstract
Objective: To determine the anthropometric measurement that best associated with angiographic severity and best predictor of major adverse cardiovascular and cerebrovascular event in patients who are successfully re-vascularized after non-ST elevation myocardial infarction.
Methodology: This is a prospective cohort study done in Cardiology unit, Lady Reading Hospital, Peshawar from 1 July, 2016 to 31 November, 2017. Cohort was selected on the basis of complete revascularization with DES after non-ST elevation MI in the first 6-months period and were followed over a period of 12 months with a 3-months clinical and monthly telephonic follow-up, to observe for any major adverse cardiovascular and cerebrovascular events (MACCE). Raised level of BMI, waist, wrist, neck circumferences and waist-to-hip ratio were defined as > 25 kg/m(2), > 102cm and > 88cm, > 20cm and > 18cm, > 40cm and 37cm for male and female, and 0.55 ratio respectively. Chi-square test used to correlate anthropometric values with angiographic severity and incidence of MACCE. Logistic regression model was applied for prediction of MACCE. Kaplan-Meier curve used for survival of these patients through one year.
Results: Total of 73 patients having successful revascularization after NSTEMI, with a mean age of 59.25 +/- 10.34 years were enrolled in the study. Of these 47.9% were males, 31 (42.4%) patients had triple vessel disease. Neck circumference was best correlated with angiographic severity (X-2=22.59) followed by BMI (X-2=22.2) with significant p-value for all except for waist circumference. Similarly, all were associated with incidence of MACCE, with wrist as the best (X-2=16.12) followed by neck circumference. Relative risk for occurrence of MACCE was with NC (RR=4.5). Kaplan Meier curves showed significant correlation of raised anthropometric values with incidence of MACCE i.e. all patients who had MACCE had raised anthropometric values except for two cases who had normal wrist circumference.
Conclusions: Raised anthropometric values are significantly associated with angiographic severity and incidence of MACCE in NSTEMI patients, with the neck circumference as its best predictor. Follow-up of these patients show similar significant results for MACCE occurrence.