{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:15:54Z","timestamp":1790741754184,"version":"4.1.0"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,5,3]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Patients with acute coronary syndrome (ACS) are recognized by guidelines as remaining at high risk for adverse outcomes. Evidence from contemporary, representative ACS populations in a clinical practice setting is necessary to identify subgroups and strategies for improving patient outcomes. We aimed to describe event rates and risk factors in an ACS population over prolonged follow\u2010up for cardiovascular end points.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      We identified 239\u00a0234 patients in the Optum Research Database (57.2% men; mean [standard deviation] age, 69.2 [12.2] years) with evidence of an ACS hospitalization (index ACS) during January 1, 2005 through December 30, 2018. Subgroups were based on index ACS event (myocardial infarction\/unstable angina and revascularization status) and the Thrombolysis In Myocardial Infarction Risk Score for Secondary Prevention. The 5\u2010year event rate for the primary end point representing nonfatal myocardial infarction, nonfatal ischemic stroke, and cardiovascular death was 33.4% (95% CI, 33.1%\u201333.7%;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). The risk of experiencing the primary end point was \u22486\u2010fold higher immediately after discharge (\u224840.9% annualized risk) as compared with the period 1+\u00a0years after hospitalization (\u22486.4% annualized risk). Among subgroups, the 5\u2010year primary end point event rate was highest for myocardial infarction without revascularization and a Thrombolysis In Myocardial Infarction Risk Score for Secondary Prevention \u22654, at 47.9% (95% CI, 47.3%\u201348.4%;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001) and 56.7% (95% CI, 55.9%\u201357.4%;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001), respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Patients with ACS remain at very high risk of experiencing recurrent cardiovascular events, particularly early after discharge, with identifiable subgroups at multifold higher risk of specific clinical end points.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.121.022198","type":"journal-article","created":{"date-parts":[[2022,4,27]],"date-time":"2022-04-27T05:38:59Z","timestamp":1651037939000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":129,"title":["Event Rates and Risk Factors for Recurrent Cardiovascular Events and Mortality in a Contemporary Post Acute Coronary Syndrome Population Representing 239\u00a0234 Patients During 2005 to 2018 in the United States"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2383-895X","authenticated-orcid":false,"given":"Dylan L.","family":"Steen","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Health and Disease Department of Medicine University of Cincinnati OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9832-0904","authenticated-orcid":false,"given":"Irfan","family":"Khan","sequence":"additional","affiliation":[{"name":"Sanofi Bridgewater NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5966-1140","authenticated-orcid":false,"given":"Katherine","family":"Andrade","sequence":"additional","affiliation":[{"name":"Optum Health Economics and Outcomes Research Eden Prairie MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3680-306X","authenticated-orcid":false,"given":"Alexandra","family":"Koumas","sequence":"additional","affiliation":[{"name":"Axtria Berkeley Heights NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4110-7675","authenticated-orcid":false,"given":"Robert P.","family":"Giugliano","sequence":"additional","affiliation":[{"name":"Cardiovascular Division Brigham and Women\u2019s Hospital Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsb1609216"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e3182742c84"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000134"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx393"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000625"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz455"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa575"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.019861"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.11.070"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2017.2289"},{"key":"e_1_3_2_12_2","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1002\/9781118032985","volume-title":"The Statistical Analysis of Time Failure Data","author":"Kalbfleisch JD","year":"2002","unstructured":"Kalbfleisch JD, Prentice RL. The Statistical Analysis of Time Failure Data. 2nd ed. John Wiley & Sons; 2002:7.","edition":"2"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.017719"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2004.02.013"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.1999.10198.x"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1924"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.018610"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0092286"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.113.000743"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1518"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1002\/pds.2312"},{"key":"e_1_3_2_22_2","volume-title":"National Death Index User\u2019s Guide","author":"National Center for Health Statistics","year":"2013","unstructured":"National Center for Health Statistics . National Death Index User\u2019s Guide. US Department of Health and Human Services, Centers for Disease Control and Prevention; 2013."},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.120.016506"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1908973"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1801174"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1410489"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1112277"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1109719"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0904327"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.119.005691"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2020.03.059"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.012161"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.03.007"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001038"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00590-0"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.2244"},{"key":"e_1_3_2_37_2","first-page":"e123","article-title":"2016 ACC\/AHA guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease. [published correction appears in Circulation. 2016 Sep 6;134(10):e192\u20104]","volume":"134","author":"Levine GN","year":"2016","unstructured":"Levine GN, Bates ER, Bittl JA, Brindis RG, Fihn SD, Fleisher LA, Granger CB, Lange RA, Mack MJ, Mauri L, et al. 2016 ACC\/AHA guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease. [published correction appears in Circulation. 2016 Sep 6;134(10):e192\u20104]. Circulation. 2016;134:e123\u2013e155. doi: 10.1161\/CIR.0000000000000404","journal-title":"Circulation"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2019.0198"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-145-10-200611210-00006"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2017.06.041"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.117.008152"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1002\/pds.3970"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.120.006589"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.06.038"},{"key":"e_1_3_2_45_2","unstructured":"SciPyorg . Scientific computing tools for Python\u2014scipy.optimize package. 2019. Available at: https:\/\/docs.scipy.org\/doc\/scipy\/reference\/tutorial\/optimize.html. Accessed October 28 2020."}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.121.022198","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T07:02:42Z","timestamp":1715583762000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.121.022198"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,3]]},"references-count":44,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2022,5,3]]}},"alternative-id":["10.1161\/JAHA.121.022198"],"URL":"https:\/\/doi.org\/10.1161\/jaha.121.022198","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,3]]},"assertion":[{"value":"2021-05-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-03-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-04-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e022198"}}