Long-Term Clinical Outcomes according to Initial Management and Thrombolysis In Myocardial Infarction Risk Score in Patients with Acute Non-ST-Segment Elevation Myocardial Infarction.
- Author:
Hae Chang JEONG
1
;
Youngkeun AHN
;
Myung Ho JEONG
;
Shung Chull CHAE
;
Seung Ho HUR
;
Taek Jong HONG
;
Young Jo KIM
;
In Whan SEONG
;
Jei Keon CHAE
;
Jay Young RHEW
;
In Ho CHAE
;
Myeong Chan CHO
;
Jang Ho BAE
;
Seung Woon RHA
;
Chong Jin KIM
;
Donghoon CHOI
;
Yang Soo JANG
;
Junghan YOON
;
Wook Sung CHUNG
;
Jeong Gwan CHO
;
Ki Bae SEUNG
;
Seung Jung PARK
Author Information
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords: Myocardial infarction; non-ST-segment elevation; invasive treatment; TIMI risk score; prognosis
- MeSH: Age Factors; Aged; Angioplasty, Transluminal, Percutaneous Coronary; Female; Fibrinolytic Agents/*therapeutic use; Hemodynamics/drug effects; Humans; Male; Middle Aged; Multivariate Analysis; Myocardial Infarction/*drug therapy/pathology/therapy; Prospective Studies; Thrombolytic Therapy/*methods
- From:Yonsei Medical Journal 2010;51(1):58-68
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: There is still debate about the timing of revascularization in patients with acute non-ST-segment elevation myocardial infarction (NSTEMI). We analyzed the long-term clinical outcomes of the timing of revascularization in patients with acute NSTEMI obtained from the Korea Acute Myocardial Infarction Registry (KAMIR). MATERIALS AND METHODS: 2,845 patients with acute NSTEMI (65.6 +/- 12.5 years, 1,836 males) who were enrolled in KAMIR were included in the present study. The therapeutic strategy of NSTEMI was categorized into early invasive (within 48 hours, 65.8 +/- 12.6 years, 856 males) and late invasive treatment (65.3 +/- 12.1 years, 979 males). The initial- and long-term clinical outcomes were compared between two groups according to the level of Thrombolysis In Myocardial Infarction (TIMI) risk score. RESULTS: There were significant differences in-hospital mortality and the incidence of major adverse cardiac events during one-year clinical follow-up between two groups (2.1% vs. 4.8%, p < 0.001, 10.0% vs. 13.5%, p = 0.004, respectively). According to the TIMI risk score, there was no significant difference of long-term clinical outcomes in patients with low to moderate TIMI risk score, but significant difference in patients with high TIMI risk score (> or = 5 points). Conclusions: The old age, high Killip class, low ejection fraction, high TIMI risk score, and late invasive treatment strategy are the independent predictors for the long-term clinical outcomes in patients with NSTEMI.
