Early- and late-term clinical outcome and their predictors in patients with ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction

Title
Early- and late-term clinical outcome and their predictors in patients with ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction
Author(s)
김영조윤창환[윤창환]강시혁[강시혁]최동주[최동주]조명찬[조명찬]권현철[권현철]박현웅[박현웅]김효수[김효수]안용건[안용건]정명호[정명호]
Keywords
ACUTE CORONARY SYNDROMES; TIMI RISK SCORE; NATIONAL REGISTRY; 30-DAY SURVIVORS; MORTALITY; MANAGEMENT; TRIAL; REVASCULARIZATION; DEFINITION; GUIDELINES
Issue Date
201311
Publisher
ELSEVIER IRELAND LTD
Citation
INTERNATIONAL JOURNAL OF CARDIOLOGY, v.169, no.4, pp.254 - 261
Abstract
Backgrounds: The disparity between ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) remains controversial. We compared clinical outcomes and prognostic factors between STEMI and NSTEMI using large-scale registry data. Methods: We recruited 28,421 patients with STEMI (n = 16,607) and NSTEMI (n = 11,814) between November 2005 and April 2010 from a nationwide registry in Korea. We performed landmark analysis of cardiac death, recurrent acute myocardial infarction (re-AMI), revascularization, and major adverse cardiac events (MACE) at 30 days (early term) and 1 year (late term) after admission. Results: Patients with NSTEMI had a greater number of co-morbidities than STEMI patients. Early term MACE (6.9% vs. 4.5%, p < 0.001) and cardiac death (6.1% vs. 3.7%, p < 0.001) were higher in STEMI patients. However, late-term MACE (8.0% vs. 9.1%, p = 0.007), cardiac death (1.9% vs. 2.6%, p = 0.001), and re-AMI (0.6% vs. 1.3%, p < 0.001) were lower in the STEMI group. The independent predictors of cardiac death were old age, renal dysfunction, LV dysfunction, Killip class, post-thrombolysis in myocardial infarction (TIMI) flow, and major bleeding in both groups. Female gender, previous ischemic heart disease, diabetes, current smoking, multivessel disease, and body mass index were MI type-or time-dependent predictors. Conclusion: The STEMI group displayed poor early term clinical outcome, whereas the NSTEMI group displayed poor late-term clinical outcome. The STEMI and NSTEMI groups had different predictor profiles for cardiac death, suggesting that different strategies are required for improving the late-term outcome of STEMI and NSTEMI patients. (C) 2013 Elsevier Ireland Ltd. All rights reserved.
URI
http://hdl.handle.net/YU.REPOSITORY/28628http://dx.doi.org/10.1016/j.ijcard.2013.08.132
ISSN
0167-5273
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의과대학 > 내과학교실 > Articles
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