[Twelve-month outcome of 658 patients with acute coronary syndrome without ST-segment elevation assigned to early invasive strategy].
We aimed at assessing the frequency of death, myocardial infarction, unstable angina, repeat revascularization, cardiovascular hospitalisation during 12 months in patients assigned to early invasive strategy.


METHODS
We analysed 658 consecutive patients with acute coronary syndrome (ACS) without ST-segment elevation hospitalized between January 2000 and February 2003. Patients had to fulfill the following criteria: 1) rest angina within 24 hours prior to admission, 2) at least one of the following: ST-segment depression (> or = 0,05 mV), transient (< 20 min) ST-segment elevation (> or = 0,05 mV), T-wave inversion (> or = 1 mV) in at least 2 contiguous leads, positive serum cardiac markers.


RESULTS
All patients underwent coronary angiography followed by PCI (percutaneous coronary interventions) in 71.8% of patients. 18.2% were assigned to CABG (coronary artery bypass graft) and 8.7% of patients were treated conservatively. 1.3% of patients underwent PCI followed by an elective CABG surgery. In-hospital mortality rate was.,3%. 3.3% patients died after hospital discharge. The frequency of myocardial infarction, unstable angina and repeat PCI at 12 months was 2.1%, 16.8% and 11.5% respectively. The rate of cardiovascular hospitalisation was 15.6%. Multivariate analysis identified two independent predictors ofdeath: diabetes mellitus (OR: 7.02, 95% CI: 1.5-13.8, p = 0.03) and heart failure (OR: 12.6, 95% CI: 2.86-16.6 p = 0.005).


CONCLUSIONS
Early invasive strategy in analysed group yields good long-term outcomes with low rate of adverse ischemic events. Independent predictors of deaths were diabetes mellitus and heart failure.
Szyguła-Jurkiewicz
Bozena
B
Z III Katedry i Oddzialu Klinicznego Kardiologii Slaskiej Akademii Medycznej, Katowicach Slaskie Centrum Chorób Serca, Zabrzu. b.szygula@sccs.pl
Wasilewski
Jarosław
J
Wilczek
Krzysztof
K
Osadnik
Tadeusz
T
Trzeciak
Przemysław
P
Lekston
Andrzej
A
Wojnicz
Romuald
R
Poloński
Lech
L
D000208:Acute Disease; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D015984:Causality; D002423:Cause of Death; D015897:Comorbidity; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality / Q000628:therapy*; D003920:Diabetes Mellitus / Q000453:epidemiology; D042241:Early Diagnosis; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000453:epidemiology; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology; D011044:Poland / Q000453:epidemiology; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome