OBJECTIVE: To analyse short- and long-term outcomes and prognostic factors in a large population-based cohort of unselected patients with a first emergency admission for suspected acute coronary syndrome between 1990 and 2000 in Scotland. METHODS: All first emergency admissions for acute myocardial infarction (AMI) and all first emergency admissions for angina (the proxy for unstable angina) between 1990 and 2000 in Scotland (population 5.1 million) were identified. Survival to five years was examined by Cox multivariate modelling to examine the independent prognostic effects of diagnosis, age, sex, year of admission, socioeconomic deprivation and co-morbidity. RESULTS: In Scotland between 1990 and 2000, 133,429 individual patients had a first emergency admission for suspected acute coronary syndrome: 96 026 with AMI and 37,403 with angina. After exclusion of deaths within 30 days, crude five-year case fatality was similarly poor for patients with angina and those with AMI (23.9% v 21.6% in men and 23.5% v 26.0% in women). The longer-term risk of a subsequent fatal or non-fatal event in the five years after first hospital admission was high: 54% in men after AMI (53% in women) and 56% after angina (49% in women). Event rates increased threefold with increasing age and 20-60% with different co-morbidities, but were 11-34% lower in women. CONCLUSIONS: Longer-term case fatality was similarly high in patients with angina and in survivors of AMI, about 5% a year. Furthermore, half the patients experienced a fatal or non-fatal event within five years. These data may strengthen the case for aggressive secondary prevention in all patients presenting with acute coronary syndrome.
OBJECTIVE: To analyse short- and long-term outcomes and prognostic factors in a large population-based cohort of unselected patients with a first emergency admission for suspected acute coronary syndrome between 1990 and 2000 in Scotland. METHODS: All first emergency admissions for acute myocardial infarction (AMI) and all first emergency admissions for angina (the proxy for unstable angina) between 1990 and 2000 in Scotland (population 5.1 million) were identified. Survival to five years was examined by Cox multivariate modelling to examine the independent prognostic effects of diagnosis, age, sex, year of admission, socioeconomic deprivation and co-morbidity. RESULTS: In Scotland between 1990 and 2000, 133,429 individual patients had a first emergency admission for suspected acute coronary syndrome: 96 026 with AMI and 37,403 with angina. After exclusion of deaths within 30 days, crude five-year case fatality was similarly poor for patients with angina and those with AMI (23.9% v 21.6% in men and 23.5% v 26.0% in women). The longer-term risk of a subsequent fatal or non-fatal event in the five years after first hospital admission was high: 54% in men after AMI (53% in women) and 56% after angina (49% in women). Event rates increased threefold with increasing age and 20-60% with different co-morbidities, but were 11-34% lower in women. CONCLUSIONS: Longer-term case fatality was similarly high in patients with angina and in survivors of AMI, about 5% a year. Furthermore, half the patients experienced a fatal or non-fatal event within five years. These data may strengthen the case for aggressive secondary prevention in all patients presenting with acute coronary syndrome.
Authors: Michel E Bertrand; Maarten L Simoons; Keith A A Fox; Lars C Wallentin; Christian W Hamm; Eugene McFadden; Pim J De Feyter; Giuseppe Specchia; Witold Ruzyllo Journal: Eur Heart J Date: 2002-12 Impact factor: 29.983
Authors: S Capewell; B M Livingston; K MacIntyre; J W Chalmers; J Boyd; A Finlayson; A Redpath; J P Pell; C J Evans; J J McMurray Journal: Eur Heart J Date: 2000-11 Impact factor: 29.983
Authors: A M Tonkin; D Colquhoun; J Emberson; W Hague; A Keech; G Lane; S MacMahon; J Shaw; R J Simes; P L Thompson; H D White; D Hunt Journal: Lancet Date: 2000-12-02 Impact factor: 79.321
Authors: K MacIntyre; S Stewart; S Capewell; J W Chalmers; J P Pell; J Boyd; A Finlayson; A Redpath; H Gilmour; J J McMurray Journal: J Am Coll Cardiol Date: 2001-09 Impact factor: 24.094
Authors: J Collinson; M D Flather; K A Fox; I Findlay; E Rodrigues; P Dooley; P Ludman; J Adgey; T J Bowker; R Mattu Journal: Eur Heart J Date: 2000-09 Impact factor: 29.983
Authors: S Capewell; K MacIntyre; S Stewart; J W Chalmers; J Boyd; A Finlayson; A Redpath; J P Pell; J J McMurray Journal: Lancet Date: 2001-10-13 Impact factor: 79.321
Authors: Frans Van de Werf; Diego Ardissino; Amadeo Betriu; Dennis V Cokkinos; Erling Falk; Keith A A Fox; Desmond Julian; Maria Lengyel; Franz-Josef Neumann; Witold Ruzyllo; Christian Thygesen; S Richard Underwood; Alec Vahanian; Freek W A Verheugt; William Wijns Journal: Eur Heart J Date: 2003-01 Impact factor: 29.983
Authors: Ankur Pandya; Stephen Sy; Sylvia Cho; Sartaj Alam; Milton C Weinstein; Thomas A Gaziano Journal: Med Decis Making Date: 2017-05-10 Impact factor: 2.583
Authors: Louai Razzouk; Verghese Mathew; Ryan J Lennon; Ashish Aneja; Joshua I Mozes; Heather J Wiste; Paul Muntner; James H Chesebro; Michael E Farkouh Journal: Clin Cardiol Date: 2010-09 Impact factor: 2.882
Authors: Rikke Sørensen; G H Gislason; E L Fosbøl; S Rasmussen; L Køber; J K Madsen; C Torp-Pedersen; S Z Abildstrom Journal: Br J Clin Pharmacol Date: 2008-09-23 Impact factor: 4.335
Authors: Michael E Farkouh; Ashish Aneja; Guy S Reeder; Peter A Smars; Sameer Bansilal; Ryan J Lennon; Heather J Wiste; Louai Razzouk; Kay Traverse; David R Holmes; Verghese Mathew Journal: Medicine (Baltimore) Date: 2009-09 Impact factor: 1.889
Authors: Majid Ezzati; Ziad Obermeyer; Ioanna Tzoulaki; Bongani M Mayosi; Paul Elliott; David A Leon Journal: Nat Rev Cardiol Date: 2015-06-16 Impact factor: 32.419
Authors: Colin R Simpson; Brian S Buckley; David J McLernon; Aziz Sheikh; Andrew Murphy; Philip C Hannaford Journal: PLoS One Date: 2011-10-20 Impact factor: 3.240