Patterns of presentation and outcomes of patients with acute coronary syndromes.
OBJECTIVE
We undertook this study to assess the relationship between presentation pattern and mortality in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention.


METHODS
This registry included 10,455 patients with ACS, of whom 2,853 patients had ST-segment elevation myocardial infarction(STEMI), 3,060 patients had non-ST-segment elevation myocardial infarction (NSTEMI) and 4,542 patients had unstable angina. The primary outcome was 1-year mortality.


RESULTS
At 1 year there were 976 deaths, 390 (13.7%) among STEMI patients, 366 (12.0%) among NSTEMI patients and 220 (4.8%) among patients with unstable angina (OR = 1.17, 95% CI 1.01-1.35 for STEMI vs. NSTEMI; OR = 3.00, 95% CI 2.56-3.51 for STEMI vs. unstable angina, and OR = 2.58, 95% CI 2.20-3.04 for NSTEMI vs. unstable angina). In the Cox proportional hazards model ACS form was an independent correlate of 1-year mortality (HR = 0.90, 95% CI 0.73-1.13 for STEMI vs. NSTEMI; HR = 1.56, 95% CI 1.13-2.14 for STEMI vs. unstable angina; HR = 1.72, 95% CI 1.30-2.29 for NSTEMI vs. unstable angina).


CONCLUSIONS
The presentation pattern affects 1-year mortality in patients with ACS, with unadjusted mortality being highest in patients with STEMI and lowest in patients with unstable angina.
Ndrepepa
Gjin
G
Deutsches Herzzentrum, Technische Universitat, Lazarettstrasse 36, Munich, Germany. ndrepepa@dhm.mhn.de
Mehilli
Julinda
J
Schulz
Stefanie
S
Iijima
Raisuke
R
Keta
Dritan
D
Byrne
Robert A
RA
Pache
Jürgen
J
Seyfarth
Melchior
M
Schömig
Albert
A
Kastrati
Adnan
A
D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D000368:Aged; D000789:Angina, Unstable / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary / Q000401:mortality*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D016016:Proportional Hazards Models; D012042:Registries; D012770:Shock, Cardiogenic / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D015607:Stents / Q000706:statistics & numerical data*