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

Title
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)
김영조정해창[정해창]안영근[안영근]정명호[정명호]채성철[채성철]허성호[허성호]홍택종[홍택종]성인완[성인완]채제근[채제근]류재영[류재영]채인호[채인호]조명찬[조명찬]배장호[배장호]라성운[라성운]김종진[김종진]최동훈[최동훈]장양수[장양수]윤정한[윤정한]정욱성[정욱성]조정관[조정관]성기배[성기배]박성정[박성정]
Keywords
ACUTE CORONARY SYNDROMES; UNSTABLE ANGINA; CONSERVATIVE STRATEGIES; GUIDELINE UPDATE; RANDOMIZED-TRIAL; TASK-FORCE; INTERVENTION; ASSOCIATION; STRATIFICATION; DEPRESSION
Issue Date
201001
Publisher
YONSEI UNIV COLLEGE MEDICINE
Citation
YONSEI MEDICAL JOURNAL, v.51, no.1, pp.58 - 68
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 (>= 5 points). Conclusion: 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.
URI
http://hdl.handle.net/YU.REPOSITORY/22992http://dx.doi.org/10.3349/ymj.2010.51.1.58
ISSN
0513-5796
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의과대학 > 내과학교실 > Articles
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