Assessing Prognosis of Acute Coronary Syndrome in Recent Clinical Trials: A Systematic Review
Autor: | Steven H. Yale, David E. Winchester, Carolyn Stalvey, Michael Jansen, Fan Ye, Arthur Lee, Burton V. Silverstein, Matheen Khuddus, Joseph J. Mazza |
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Rok vydání: | 2019 |
Předmět: |
Male
030213 general clinical medicine Acute coronary syndrome medicine.medical_specialty Time Factors Review Disease Disease-Free Survival Angina 03 medical and health sciences Sex Factors 0302 clinical medicine Internal medicine medicine Animals Humans ST segment Myocardial infarction Acute Coronary Syndrome Aged Community and Home Care business.industry Mortality rate General Medicine Middle Aged medicine.disease Survival Rate Clinical trial Disease Models Animal Heart failure ST Elevation Myocardial Infarction Female business |
Zdroj: | Clinical Medicine & Research. 17:11-19 |
ISSN: | 1554-6179 1539-4182 |
Popis: | There is no recent comprehensive overview of contemporary clinical trials assessing short and long-term outcomes in patients with acute coronary syndrome (ACS). This paper reviews factors from recent clinical trials that influenced prognosis in patients with ACS. Cochrane and PubMed databases were screened systematically for clinical trials published in the English literature reporting on ACS prognosis. Two authors independently screened titles, abstracts, and full text. Studies meeting inclusion criteria evaluated the impact of modern practice on prognosis. In vitro and animal models studies, conference abstracts, imaging studies, and review articles were excluded. Disagreement in inclusion criteria was resolved by consensus. A large study of 8,859 patients showed no difference in all-cause mortality between 31 days and 2 years in patients with ST segment elevation myocardial infarction (STEMI) compared to those with non-ST segment elevation myocardial infarction (NSTEMI) or stable ischemic heart disease (SIHD). Other studies showed a significant increase in all-cause mortality in patients with STEMI within the first 30 days, with NSTEMI patients exhibiting a higher mortality rate compared to those with SIHD during the 2-year follow-up period. Our review found that women have a poorer short-term prognosis compared to men. Additionally, reports from patients receiving comprehensive and coordinated care showed longer survival rates. In view of the improved prognosis demonstrated for patients suffering from ACS, assessing prognosis in patients represents a formidable task in modern practice. Our review highlights the need for further evidence-based studies evaluating long-term outcomes on diagnostic and treatment strategies. |
Databáze: | OpenAIRE |
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