Intensive pharmacologic treatment in patients with acute non ST-segment elevation myocardial infarction who did not undergo percutaneous coronary intervention.
BACKGROUND
The aim of this study was to assess the impact of more aggressive pharmacological treatment on short-term clinical outcomes in patients with acute non ST-segment elevation myocardial infarction (NSTEMI) who do not undergo percutaneous coronary intervention (PCI).


RESULTS
The 924 NSTEMI patients treated with early conservative strategy (69.2+/-12.5 years, 637 males) in 50 hospitals that were high-volume centers with facilities for primary PCI were recruited to the Korean Acute Myocardial Infarction Registry (KAMIR) from November 2005 to August 2007. For all patients, the pharmacotherapy index based on the use of drugs during hospital stay was assessed (range of points 0-10). Primary endpoint was the combined in-hospital mortality and morbidity and major adverse cardiac events during 1 month of clinical follow-up. Of the patients, data from 847 who were followed-up for 1 month after discharge were analyzed. The rate of the primary endpoint decreased with an increase of the pharmacotherapy index and this result was similar in the low- and high-risk groups. In the multivariate analysis, low pharmacotherapy index (<or=4 points) was an independent predictor of the primary endpoint.


CONCLUSIONS
More intensive pharmacological treatment may improve short-term clinical outcomes in acute NSETMI patients who do not undergo PCI.
Jeong
Hae Chang
HC
Heart Center of Chonnam National University Hospital, Gwangju, Republic of Korea.
Ahn
Young Keun
YK
Jeong
Myung Ho
MH
Chae
Shung Chull
SC
Kim
Jong Hyun
JH
Seong
In Whan
IW
Kim
Young Jo
YJ
Hur
Seung Ho
SH
Choi
Dong Hoon
DH
Hong
Taek Jong
TJ
Yoon
Jung Han
JH
Rhew
Jae Young
JY
Chae
Jei Keon
JK
Kim
Doo Il
DI
Chae
In Ho
IH
Koo
Bon Kwon
BK
Kim
Byung Ok
BO
Lee
Nae Hee
NH
Hwang
Jin Yong
JY
Oh
Seok Kyu
SK
Cho
Myeong Chan
MC
Kim
Kee Sik
KS
Jeong
Kyoung Tae
KT
Lee
Myoung Yong
MY
Kim
Chong Jin
CJ
Chung
Wook Sung
WS
D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate