Long-Term Clinical Outcomes according to initial management and thrombolysis in myocardial infarction risk score in patients with acute non-ST-segment elevation myocardial infarction
- Author(s)
- Hae Chang Jeong; Young Keun Ahn; Myung Ho Jeong; Shung Chull Chae; Seung Ho Hur; Taek Jong Hong; Young Jo Kim; In Whan Seong; Jei Keon Chae; Jay Young Rhew; In Ho Chae; Myeong Chan Cho; Jang Ho Bae; Seung Woon Rha; Chong Jin Kim; Donghoon Choi; Yang Soo Jang; Junghan Yoon; Wook Sung Chung; Jeong Gwan Cho; Ki Bae Seung; Seung Jung Park; Other Korea Acute Myocardial Infarction Registry
Investigators
- Keimyung Author(s)
- Hur, Seung Ho
- Department
- Dept. of Internal Medicine (내과학)
- Journal Title
- Yonsei Medical Journal
- Issued Date
- 2010
- Volume
- 51
- Issue
- 1
- Abstract
- PURPOSE: There is still debate about the timing of revascularization in patients with acute non-ST-segment elevation myocardial infarction (NSTEMI). We analyzed the long-term clinical outcomes of the timing of revascularization in patients with acute NSTEMI obtained from the Korea Acute Myocardial Infarction Registry (KAMIR).
MATERIALS AND METHODS:
2,845 patients with acute NSTEMI (65.6 +/- 12.5 years, 1,836 males) who were enrolled in KAMIR were included in the present study. The therapeutic strategy of NSTEMI was categorized into early invasive (within 48 hours, 65.8 +/- 12.6 years, 856 males) and late invasive treatment (65.3 +/- 12.1 years, 979 males). The initial- and long-term clinical outcomes were compared between two groups according to the level of Thrombolysis In Myocardial Infarction (TIMI) risk score.
RESULTS:
There were significant differences in-hospital mortality and the incidence of major adverse cardiac events during one-year clinical follow-up between two groups (2.1% vs. 4.8%, p < 0.001, 10.0% vs. 13.5%, p = 0.004, respectively). According to the TIMI risk score, there was no significant difference of long-term clinical outcomes in patients with low to moderate TIMI risk score, but significant difference in patients with high TIMI risk score (>or= 5 points).
CONCLUSIONS:
The old age, high Killip class, low ejection fraction, high TIMI risk score, and late invasive treatment strategy are the independent predictors for the long-term clinical outcomes in patients with NSTEMI.
KEYWORDS:
Myocardial infarction; TIMI risk score; invasive treatment; non-ST-segment elevation; prognosis
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