BACKGROUND: Prognoses in STEMI and NSTEMI beyond one year from onset remain unclear. We aimed to compare the treatments and the two-year outcomes in patients with myocardial infarction (MI) enrolled at the Polish Registry of Acute Coronary Syndromes (PL-ACS). METHODS: A total of 13,441 patients with MI (8250 with STEMI, and 5191 with NSTEMI) underwent medical care between October 2003 and June 2005 in the Silesia region (4.8 million inhabitants). The events analyzed were death, MI, stroke and percutaneous (PCI) or surgical (CABG) revascularization. RESULTS: After two years, NSTEMI was associated with a higher incidence of death (hazard ratio (HR) of 1.09 (95% confidence interval (CI) 1.02-1.17, p<0.0001)); a higher incidence of reinfarction, stroke, CABG and a lower rate of PCI. Adjustments for baseline characteristics and treatment strategy (invasive vs. non-invasive) reversed the HR for mortality and eliminated the difference in MI and stroke. The adjusted HR for mortality was 0.76 (95% CI, 0.71-0.83, p<0.0001). STEMI and NSTEMI patients treated non-invasively were older and showed higher incidences of diabetes, obesity, pulmonary edema and cardiogenic shock than their invasively treated counterparts. Invasively treated patients received aspirin, beta-blockers, ACE inhibitors and statins more often during hospitalization and at discharge. CONCLUSIONS: The unadjusted long-term prognosis was worse in NSTEMI. After adjustment for the baseline characteristics and treatment strategy, the long-term prognosis was worse in STEMI. Patients with MI treated invasively showed more favorable clinical characteristics and received guideline-recommended therapy more often than patients who did not undergo invasive treatment.
BACKGROUND: Prognoses in STEMI and NSTEMI beyond one year from onset remain unclear. We aimed to compare the treatments and the two-year outcomes in patients with myocardial infarction (MI) enrolled at the Polish Registry of Acute Coronary Syndromes (PL-ACS). METHODS: A total of 13,441 patients with MI (8250 with STEMI, and 5191 with NSTEMI) underwent medical care between October 2003 and June 2005 in the Silesia region (4.8 million inhabitants). The events analyzed were death, MI, stroke and percutaneous (PCI) or surgical (CABG) revascularization. RESULTS: After two years, NSTEMI was associated with a higher incidence of death (hazard ratio (HR) of 1.09 (95% confidence interval (CI) 1.02-1.17, p<0.0001)); a higher incidence of reinfarction, stroke, CABG and a lower rate of PCI. Adjustments for baseline characteristics and treatment strategy (invasive vs. non-invasive) reversed the HR for mortality and eliminated the difference in MI and stroke. The adjusted HR for mortality was 0.76 (95% CI, 0.71-0.83, p<0.0001). STEMI and NSTEMI patients treated non-invasively were older and showed higher incidences of diabetes, obesity, pulmonary edema and cardiogenic shock than their invasively treated counterparts. Invasively treated patients received aspirin, beta-blockers, ACE inhibitors and statins more often during hospitalization and at discharge. CONCLUSIONS: The unadjusted long-term prognosis was worse in NSTEMI. After adjustment for the baseline characteristics and treatment strategy, the long-term prognosis was worse in STEMI. Patients with MI treated invasively showed more favorable clinical characteristics and received guideline-recommended therapy more often than patients who did not undergo invasive treatment.
Authors: David D Berg; Stephen D Wiviott; Eugene Braunwald; Jianping Guo; KyungAh Im; Amir Kashani; C Michael Gibson; Christopher P Cannon; David A Morrow; Deepak L Bhatt; Jessica L Mega; Michelle L O'Donoghue; Elliott M Antman; L Kristin Newby; Marc S Sabatine; Robert P Giugliano Journal: Eur Heart J Date: 2018-11-07 Impact factor: 29.983
Authors: Dharam J Kumbhani; Brian J Wells; A Michael Lincoff; Anil Jain; Susana Arrigain; Changhong Yu; Marlene Goormastic; Stephen G Ellis; Eugene Blackstone; Michael W Kattan Journal: Am J Cardiovasc Dis Date: 2013-02-17
Authors: Fan Ye; David Winchester; Michael Jansen; Arthur Lee; Burton Silverstein; Carolyn Stalvey; Matheen Khuddus; Joseph Mazza; Steven Yale Journal: Clin Med Res Date: 2019-06
Authors: María José Martínez; Ferran Rueda; Carlos Labata; Teresa Oliveras; Santiago Montero; Marc Ferrer; Nabil El Ouaddi; Jordi Serra; Josep Lupón; Antoni Bayés-Genís; Cosme García-García Journal: J Clin Med Date: 2022-06-20 Impact factor: 4.964
Authors: A Viveiros Monteiro; R Ramos; A Fiarresga; L de Sousa; D Cacela; L Patrício; L Bernardes; C Soares; R Cruz Ferreira Journal: Herz Date: 2016-06-30 Impact factor: 1.443