Residual risk after acute coronary syndrome: the PRATO-ACS Registry

Abstract Background Despite administration of current evidence-based therapies, substantial residual risk for cardiovascular events persists, particularly after acute coronary syndrome (ACS). It is well known that different inflammatory, metabolic, renal factors concur in defining the risk, beyond lipids, platelets and coagulation. Purpose The purpose this study to analyze prevalence various patients at 1 month ACS their association with all-cause death within 3 years. Methods Of 1585 admitted our center included PRATO-ACS Registry we selected 1099 (69±12 yrs; 30% female; 26.7% diabetes; 73% NSTE-ACS 27% STEMI) who underwent laboratory analyses index event. All had undergone early invasive strategy received high intensity statins during hospitalization discharge. frequency 5 specific was evaluated: LDL cholesterol ≥70 mg/dl; sensitivity C reactive protein (hs-CRP) ≥2 mg/l; triglycerides ≥135 glycosylated hemoglobin (HbA1c) ≥6.5% diabetic ≥5.7% non-diabetic patients; decrease estimated glomerular filtration rate (eGFR) ≥25% compared baseline. Patients were followed up three between individual years evaluated Cox proportional analysis expressed by hazard ratio (HR) 95% confidence intervals (CI). Results Table lists five mortality HR (95% CI) each factor. Conclusions After ACS, despite secondary prevention therapy (high statins), factors, all measured month, are persistently elevated majority patients. Their significantly inflammatory metabolic parameters as function deterioration. These findings should prod us develop new strategies target not only lipid profile. FUNDunding Acknowledgement Type funding sources: None.