E Chong1, L Shen, H C Tan, K K Poh. 1. Cardiology Department, Jurong Health, Alexandra Hospital and National University Hospital, 378 Alexandra Road, Singapore 159964. ericchong80@hotmail.com
Abstract
INTRODUCTION: Thrombolysis in Myocardial Infarction (TIMI) score has been used to predict outcomes in patients presenting with unstable angina (UA) and non-ST elevation myocardial infarction (NSTEMI). Our study assessed other clinical predictors for patients with UA/NSTEMI undergoing early percutaneous coronary intervention (PCI). MATERIALS AND METHODS: A cohort of 3822 patients presented with UA/NSTEMI from June 2001 to March 2008 in our center were recruited. Patients underwent PCI during admission. We analyzed the potential risk predictors for major adverse cardiac events (MACE) and death at 1 month and 6 month. RESULTS: Median age was 57.1 +/- 11.1, 78.1 percent men, 34.5 percent had diabetes, 58.8 percent had hypertension. Coronary lesions involving left main and proximal left anterior descending artery was 27.6 percent. 36.1 percent had NSTEMI. Significant predictors for mortality at 6 months were age older than 70 years (p = 0.001, OR = 5.5), female gender (p = 0.001, OR = 2.98), anaemia (p < 0.001 OR = 8.47), baseline renal impairment (P < 0.001, OR = 7.38) and development of contrast nephropathy (CIN) which was defined as 25% or 0.5 mg/dl increase from baseline Creatinine within 48 h after PCI (p = 0.005, OR = 5.8). Diabetes was a predictor of MACE at 6 months (p = 0.003, OR = 1.51) but not mortality. CONCLUSIONS: In patients with UA/NSTEMI, our study showed that MACE and mortality were increased in elderly, female and presence of anaemia. Mortality, but not MACE was increased in chronic renal impairment and development of CIN; while diabetes increased only MACE, but not mortality. SUMMARY: We analyzed a cohort of 3822 patients with UA/NSTEMI underwent PCI and found that elderly, female, presence of anemia, diabetes and chronic renal impairment were high risk predictors for adverse clinical outcome. In addition, development of CIN increased mortality.
INTRODUCTION:Thrombolysis in Myocardial Infarction (TIMI) score has been used to predict outcomes in patients presenting with unstable angina (UA) and non-ST elevation myocardial infarction (NSTEMI). Our study assessed other clinical predictors for patients with UA/NSTEMI undergoing early percutaneous coronary intervention (PCI). MATERIALS AND METHODS: A cohort of 3822 patients presented with UA/NSTEMI from June 2001 to March 2008 in our center were recruited. Patients underwent PCI during admission. We analyzed the potential risk predictors for major adverse cardiac events (MACE) and death at 1 month and 6 month. RESULTS: Median age was 57.1 +/- 11.1, 78.1 percent men, 34.5 percent had diabetes, 58.8 percent had hypertension. Coronary lesions involving left main and proximal left anterior descending artery was 27.6 percent. 36.1 percent had NSTEMI. Significant predictors for mortality at 6 months were age older than 70 years (p = 0.001, OR = 5.5), female gender (p = 0.001, OR = 2.98), anaemia (p < 0.001 OR = 8.47), baseline renal impairment (P < 0.001, OR = 7.38) and development of contrast nephropathy (CIN) which was defined as 25% or 0.5 mg/dl increase from baseline Creatinine within 48 h after PCI (p = 0.005, OR = 5.8). Diabetes was a predictor of MACE at 6 months (p = 0.003, OR = 1.51) but not mortality. CONCLUSIONS: In patients with UA/NSTEMI, our study showed that MACE and mortality were increased in elderly, female and presence of anaemia. Mortality, but not MACE was increased in chronic renal impairment and development of CIN; while diabetes increased only MACE, but not mortality. SUMMARY: We analyzed a cohort of 3822 patients with UA/NSTEMI underwent PCI and found that elderly, female, presence of anemia, diabetes and chronic renal impairment were high risk predictors for adverse clinical outcome. In addition, development of CIN increased mortality.