Patterns of presentation and outcomes of patients with acute coronary syndromes

Gjin Ndrepepa, Julinda Mehilli, Stefanie Schulz, Raisuke Iijima, Dritan Keta, Robert A. Byrne, Jürgen Pache, Melchior Seyfarth, Albert Schömig, Adnan Kastrati

Research output: Contribution to journalArticlepeer-review

34 Scopus citations

Abstract

Objectives: We undertook this study to assess the relationship between presentation pattern and mortality in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention. Methods: This registry included 10,455 patients with ACS, of whom 2,853 patients had ST-segment elevation myocardial infarction(STEMI), 3,060 patients had non-ST-segment elevation myocardial infarction (NSTEMI) and 4,542 patients had unstable angina. The primary outcome was 1-year mortality. Results: At 1 year there were 976 deaths, 390 (13.7%) among STEMI patients, 366 (12.0%) among NSTEMI patients and 220 (4.8%) among patients with unstable angina (OR = 1.17, 95% CI 1.01-1.35 for STEMI vs. NSTEMI; OR = 3.00, 95% CI 2.56-3.51 for STEMI vs. unstable angina, and OR = 2.58, 95% CI 2.20-3.04 for NSTEMI vs. unstable angina). In the Cox proportional hazards model ACS form was an independent correlate of 1-year mortality (HR = 0.90, 95% CI 0.73-1.13 for STEMI vs. NSTEMI; HR = 1.56, 95% CI 1.13-2.14 for STEMI vs. unstable angina; HR = 1.72, 95% CI 1.30-2.29 for NSTEMI vs. unstable angina). Conclusions: The presentation pattern affects 1-year mortality in patients with ACS, with unadjusted mortality being highest in patients with STEMI and lowest in patients with unstable angina.

Original languageEnglish
Pages (from-to)198-206
Number of pages9
JournalCardiology (Switzerland)
Volume113
Issue number3
DOIs
StatePublished - May 2009

Keywords

  • Acute coronary syndrome
  • Mortality
  • Percutaneous coronary intervention

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