Back to Search
Start Over
[Clinical characteristics, in-hospital outcomes and predictors of in-hospital mortality in patients with acute coronary syndromes without persistent ST-segment elevation assigned to early invasive treatment strategy].
- Source :
-
Przeglad lekarski [Przegl Lek] 2005; Vol. 62 (5), pp. 265-9. - Publication Year :
- 2005
-
Abstract
- Background: Early invasive strategy is one of alternative methods for management of acute coronary syndromes (ACS) without persistent ST-segment elevation.<br />Hypothesis: The aim of the study was analysis of clinical characteristics, in-hospital outcome and factors of in-hospital mortality.<br />Methods: The study group comprised 853 patients who were defined as high-risk, based on resting pain episodes within previous 24 hours, changes of ST-T segment in ECG, and elevated serum cardiac markers. All patients underwent coronary angiography followed by PCI (percutaneous coronary interventions) in 73.1% of patients. 16.7% were assigned to CABG (coronary artery bypass graft), 1.6% of patients underwent PCI and CABG and 8.6% of patients were treated conservatively.<br />Results: Overall in-hospital mortality was 3%; 1.4% in the PCI group, 8.4% in the CABG group and 6.8% in conservatively treated patients. The independent risk factors of in-hospital deaths were: Braunwald's IIIC class angina (OR 7.8; 95%CI 3.6-12.37 p=0.004), recurrent angina after revascularization (OR 13.04; 95%CI 7.62-29.23 p=0.002), congestive heart failure (OR 11.45; 95%CI 8.01-18,38 p=0.00001) and evolving myocardial infarction with ST-segment elevation (OR 12.77; 95%CI 8.35-27.35 p=0.0001). Stent implantation was associated with decreased risk of in-hospital death (OR 0.12; 95%CI 0.07-0.41; p=0.003).<br />Conclusions: Early invasive strategy in patients with ACS without ST-segment elevation is efficacious method of treatment. Independent predictors of in-hospital deaths are: Braunwald's IIIC class angina, congestive heart failure, recurrent angina after revascularization, myocardial infarction complicating hospital course. Stent implantation improves in-hospital prognosis.
- Subjects :
- Acute Disease
Aged
Aged, 80 and over
Angina, Unstable mortality
Angina, Unstable therapy
Confidence Intervals
Coronary Artery Disease physiopathology
Female
Heart Failure mortality
Heart Failure therapy
Hospital Mortality
Humans
Hyperlipidemias complications
Hypertension complications
Male
Middle Aged
Myocardial Infarction mortality
Myocardial Infarction therapy
Myocardial Revascularization
Odds Ratio
Poland epidemiology
Retrospective Studies
Risk Factors
Sex Factors
Survival Analysis
Time Factors
Treatment Outcome
Angioplasty, Balloon, Coronary
Coronary Artery Bypass
Coronary Artery Disease mortality
Coronary Artery Disease therapy
Subjects
Details
- Language :
- Polish
- ISSN :
- 0033-2240
- Volume :
- 62
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Przeglad lekarski
- Publication Type :
- Academic Journal
- Accession number :
- 16334529