Dataset related to the article "Non-stenotic fibro-calcific aortic valve as a predictor of myocardial infarction recurrence"

This record contains raw data related to the article "Non-stenotic fibro-calcific aortic valve as a predictor of myocardial infarction recurrence" Aims Patients with acute myocardial infarction (AMI) are at increased risk of recurrent cardiovascular events. Non-stenotic aortic valve fibro-calcific remodelling (called aortic valve sclerosis; AVSc), reflecting systemic damage, may serve as a new marker of risk. This study aims to stratify subgroups of AMI patients with specific probabilities of recurrent AMI and to evaluate the importance of AVSc in this setting. Methods and results Consecutive AMI patients (n = 2530) were admitted at Centro Cardiologico Monzino (2010–19) and followed up for 5 years. Patients were divided into study (n = 1070) and test (n = 966) cohorts. Topological data analysis (TDA) was used to stratify patient subgroups, while Kaplan–Meier and Cox regression analyses were used to evaluate the significance of baseline characteristics. Topological data analysis identified 11 subgroups of AMI patients with specific baseline characteristics. Two subgroups showed the highest rate of re-infarction after 5 years from the indexed AMI with a combined hazard ratio (HR) of 3.8 [95% confidence interval (CI): 2.7–5.4] compared with the other subgroups. This was confirmed in the test cohort (HR = 3.1; 95% CI: 2.2–4.3). These two subgroups were mostly men, with hypertension and dyslipidaemia, who exhibita higher prevalence of AVSc, higher levels of high-sensitive C-reactive protein and creatinine. In the year-by-year analysis, AVSc, adjusted for all confounders, showed an independent association with the increased risk of re-infarction (odds ratio of ∼2 at all time points), in both the study and the test cohorts (all P < 0.01). Conclusion AVSc is a crucial variable for identifying AMI patients at high risk of recurrent AMI and its presence should be considered when assessing the management of AMI patients. The inclusion of AVSc in risk stratification models may improve the accuracy of predicting the likelihood of recurrent AMI, leading to more personalized treatment decisions.本数据集包含与题为《非狭窄性纤维钙化主动脉瓣作为心肌梗死复发预测因子》的学术论文相关的原始数据。 研究目标 急性心肌梗死（acute myocardial infarction, AMI）患者发生复发性心血管事件的风险显著升高。非狭窄性主动脉瓣纤维钙化重塑（又称主动脉瓣硬化，aortic valve sclerosis, AVSc）可反映全身系统性损伤，有望成为新型风险标志物。本研究旨在对具有不同复发性AMI风险概率的AMI患者亚组进行分层，并评估AVSc在该临床场景中的价值。 方法与结果 研究对象为2010年至2019年在蒙齐诺心脏中心（Centro Cardiologico Monzino）收治的连续性AMI患者（n=2530），随访时长为5年。将患者分为训练队列（n=1070）与验证队列（n=966）。采用拓扑数据分析（Topological Data Analysis, TDA）对患者亚组进行分层，并通过Kaplan-Meier分析与Cox回归分析评估基线特征的临床意义。拓扑数据分析共识别出11个具有独特基线特征的AMI患者亚组。与其余亚组相比，其中2个亚组在首发AMI后5年内的再梗死发生率最高，合并风险比（hazard ratio, HR）为3.8[95%置信区间（confidence interval, CI）：2.7~5.4]。该结果在验证队列中得到验证（HR=3.1；95%CI：2.2~4.3）。这两个亚组以男性为主，合并高血压与血脂异常，且AVSc患病率更高、高敏C反应蛋白与肌酐水平更高。逐年分析结果显示，在校正所有混杂因素后，AVSc与再梗死风险升高存在独立相关性（在所有时间点的比值比约为2），该结果在训练队列与验证队列中均成立（所有P<0.01）。 结论 AVSc是识别复发性AMI高风险AMI患者的关键变量，在评估AMI患者的诊疗方案时应考虑其存在情况。将AVSc纳入风险分层模型可提升复发性AMI发生概率的预测准确性，从而辅助制定更具个体化的治疗决策。