Open AccessPrognostic impact of comorbidity measures on outcomes following acute coronary syndrome: A systematic review
Author(s) -
Zhang Fangyuan,
Wong Chunwai,
Chiu Yida,
Ensor Joie,
Mohamed Mohamed O.,
Peat George,
Mamas Mamas A.
Publication year - 2021
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/ijcp.14345
Subject(s) - comorbidity , medicine , confounding , medline , acute coronary syndrome , intensive care medicine , myocardial infarction , political science , law
Abstract Aim To identify existing comorbidity measures and summarise their association with acute coronary syndrome (ACS) outcomes. Methods We searched published studies from MEDLINE (OVIDSP) and EMBASE from inception to March 2021, studies of the pre‐specified conference proceedings from Web of Science since May 2017, and studies included in any relevant systematic reviews. Studies that reported no comorbidity measures, no association of comorbid burden with ACS outcomes, or only used a comorbidity measure as a confounder without further information were excluded. After independent screening by three reviewers, data extraction and risk of bias assessment of each included study was undertaken. Results were narratively synthesised. Results Of 4166 potentially eligible studies identified, 12 (combined n = 6 885 982 participants) were included. Most studies had a high risk of bias at quality assessment. Six different types of comorbidity measures were identified with the Charlson comorbidity index (CCI) the most widely used measure among studies. Overall, the greater the comorbid burden or the higher comorbidity scores recorded, the greater was the association with the risk of mortality. Conclusion The review summarised different comorbidity measures and reported that higher comorbidity scores were associated with worse ACS outcomes. The CCI is the most widely measure of comorbid burden and shows additive value to clinical risk scores in use.