Kardiologia polska · 2018
Risk factors for adverse outcomes of patients with acute coronary syndrome: single-centre experience with long-term follow-up of treated patients.
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Grabowski Marcin, Filipiak Krzysztof J, Opolski Grzegorz, Główczyńska Renata, Gawałko Monika, Balsam Paweł, Cacko Andrzej, Huczek Zenon, Karpiński Grzegorz, Kowalik Robert, Majstrak Franciszek, Kochman Janusz
Аннотация
BACKGROUND: For patients experiencing an acute coronary syndrome (ACS), a crucial time to assess their prognosis and to plan management is at discharge from hospital.
AIM: The aim of the study was to identify risk factors of mortality during post-discharge period following a hospitalisation for ACS.
METHODS: We studied 672 consecutive ACS patients hospitalised and discharged alive between 2002 and 2004. The analysis was done with respect to the type of ACS, i.e. unstable angina/non-ST-segment elevation myocardial infraction (UA/NSTEMI; n = 255) vs. ST-segment elevation myocardial infarction (STEMI; n = 417). All patients underwent coronary angiography and, if indicated, primary angioplasty (STEMI: 417 patients; UA/NSTEMI: 157 patients). The Cox proportional hazards regression model was used to evaluate the independent effect of the risk factors on the occurrence of primary endpoint, i.e. all-cause mortality during six-year follow-up. Survival status and date of death were obtained from the National Registry of Population (PESEL database).
RESULTS: A total of 123 patients (18.3%) died within the post-discharge period. The multivariate analysis identified 11 highly significant independent predictors of mortality (in order of predictive strength): diabetes mellitus (all types), higher creatinine level, older age, and more frequent occurrence of: supraventricular arrhythmias during hospitalisation, peripheral artery disease, recurrent angina pectoris with documented ischaemia on electrocardiogram, male sex, prior myocardial infarction, treatment with intra-aortic balloon pump counterpulsation, heart failure, and higher peak levels of creatine kinase-MB.
CONCLUSIONS: The risk factors obtained from the medical history and during the hospitalisation improve the risk stratification during the post-discharge period after hospitalisation for ACS.
AIM: The aim of the study was to identify risk factors of mortality during post-discharge period following a hospitalisation for ACS.
METHODS: We studied 672 consecutive ACS patients hospitalised and discharged alive between 2002 and 2004. The analysis was done with respect to the type of ACS, i.e. unstable angina/non-ST-segment elevation myocardial infraction (UA/NSTEMI; n = 255) vs. ST-segment elevation myocardial infarction (STEMI; n = 417). All patients underwent coronary angiography and, if indicated, primary angioplasty (STEMI: 417 patients; UA/NSTEMI: 157 patients). The Cox proportional hazards regression model was used to evaluate the independent effect of the risk factors on the occurrence of primary endpoint, i.e. all-cause mortality during six-year follow-up. Survival status and date of death were obtained from the National Registry of Population (PESEL database).
RESULTS: A total of 123 patients (18.3%) died within the post-discharge period. The multivariate analysis identified 11 highly significant independent predictors of mortality (in order of predictive strength): diabetes mellitus (all types), higher creatinine level, older age, and more frequent occurrence of: supraventricular arrhythmias during hospitalisation, peripheral artery disease, recurrent angina pectoris with documented ischaemia on electrocardiogram, male sex, prior myocardial infarction, treatment with intra-aortic balloon pump counterpulsation, heart failure, and higher peak levels of creatine kinase-MB.
CONCLUSIONS: The risk factors obtained from the medical history and during the hospitalisation improve the risk stratification during the post-discharge period after hospitalisation for ACS.