Early revascularization and long-term mortality in high-risk patients with non-ST-elevation myocardial infarction. The CARDIOCHUS-HUSJ registry
| Autor: | Ana Belen Cid Alvarez, Belén Álvarez Álvarez, Charigan Abou Jokh Casas, Rosa Agra Bermejo, José Ramón González Juanatey, Francisco Gude Sampedro, José María García Acuña, Álvaro Martínez Gómez, Alberto Cordero |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Acute coronary syndrome Time Factors Cardiovascular mortality GRACE score NSTEACS 030204 cardiovascular system & hematology Coronary Angiography Electrocardiography 03 medical and health sciences Percutaneous Coronary Intervention 0302 clinical medicine Risk Factors Interquartile range Cause of Death Internal medicine medicine Humans Registries Non-ST Elevated Myocardial Infarction Propensity Score Early coronary intervention Retrospective Studies Proportional hazards model business.industry Hazard ratio High-risk patients Retrospective cohort study Real world General Medicine Prognosis medicine.disease All-cause mortality Confidence interval Survival Rate Spain Cohort Propensity score matching business Follow-Up Studies |
| Zdroj: | REVISTA ESPANOLA DE CARDIOLOGIA r-FISABIO: Repositorio Institucional de Producción Científica Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO) r-FISABIO. Repositorio Institucional de Producción Científica instname |
| ISSN: | 0300-8932 |
| Popis: | Introduction and objectives: This study sought to analyze the association of early coronary angiography with all-cause mortality and cardiovascular mortality in patients with non-ST-segment elevation acute coronary syndrome (NSTEACS) using a large contemporary cohort of patients with NSTEACS from 2 Spanish tertiary hospitals. Methods: This retrospective observational study included 5673 consecutive NSTEACS patients from 2 Spanish hospitals between 2005 and 2016. We performed propensity score matching to obtain a well-balanced subset of patients with the same probability of undergoing an early strategy, resulting in 3780 patients. Survival analyses were performed by Cox regression models once proportional risk test were verified. Results: Among the study participants, only 2087 patients (40.9%) underwent early invasive coronary angiography. The median follow-up was 59.0 months [interquartile range, 25.0-80.0 months]. All-cause mortality was 19.0%, cardiovascular mortality was 12.8%, and 51.1% patients experienced at least 1 major cardiovascular adverse event in the follow-up. After propensity score matching, the early strategy was associated with significantly lower mortality (hazard ratio: 0.79; 95% confidence interval 0.62-0.98) in high-risk NSTEACS patients. The early strategy showed a nonsignificant inverse tendency in patients with GRACE score < 140. Conclusions: In high-risk (GRACE score >= 140) NSTEACS patients in a contemporary real-world registry, early coronary angiography (first 24 hours after hospital admission) may be associated with reduced all-cause mortality and cardiovascular mortality at long-term follow-up. (C) 2019 Sociedad Espanola de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved. |
| Databáze: | OpenAIRE |
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