title: Long-Term clinical outcomes according to initial management and thrombolysis in myocardial infarction risk score in patients with acute non-ST-segment elevation myocardial infarction.
abstract: OBJECTIVE
  There is still debate about the timing of revascularization in patients with acute non-ST-segment elevation myocardial infarction (NSTEMI). We analyzed the long-term clinical outcomes of the timing of revascularization in patients with acute NSTEMI obtained from the Korea Acute Myocardial Infarction Registry (KAMIR).
  
  
  METHODS
  2,845 patients with acute NSTEMI (65.6 +/- 12.5 years, 1,836 males) who were enrolled in KAMIR were included in the present study. The therapeutic strategy of NSTEMI was categorized into early invasive (within 48 hours, 65.8 +/- 12.6 years, 856 males) and late invasive treatment (65.3 +/- 12.1 years, 979 males). The initial- and long-term clinical outcomes were compared between two groups according to the level of Thrombolysis In Myocardial Infarction (TIMI) risk score.
  
  
  RESULTS
  There were significant differences in-hospital mortality and the incidence of major adverse cardiac events during one-year clinical follow-up between two groups (2.1% vs. 4.8%, p < 0.001, 10.0% vs. 13.5%, p = 0.004, respectively). According to the TIMI risk score, there was no significant difference of long-term clinical outcomes in patients with low to moderate TIMI risk score, but significant difference in patients with high TIMI risk score (>or= 5 points).
  
  
  CONCLUSIONS
  The old age, high Killip class, low ejection fraction, high TIMI risk score, and late invasive treatment strategy are the independent predictors for the long-term clinical outcomes in patients with NSTEMI.
authors.affiliation: Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Hae Chang
authors.initials: HC
authors.lastname: Jeong
authors.forename: Youngkeun
authors.initials: Y
authors.lastname: Ahn
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.forename: Shung Chull
authors.initials: SC
authors.lastname: Chae
authors.forename: Seung Ho
authors.initials: SH
authors.lastname: Hur
authors.forename: Taek Jong
authors.initials: TJ
authors.lastname: Hong
authors.forename: Young Jo
authors.initials: YJ
authors.lastname: Kim
authors.forename: In Whan
authors.initials: IW
authors.lastname: Seong
authors.forename: Jei Keon
authors.initials: JK
authors.lastname: Chae
authors.forename: Jay Young
authors.initials: JY
authors.lastname: Rhew
authors.forename: In Ho
authors.initials: IH
authors.lastname: Chae
authors.forename: Myeong Chan
authors.initials: MC
authors.lastname: Cho
authors.forename: Jang Ho
authors.initials: JH
authors.lastname: Bae
authors.forename: Seung Woon
authors.initials: SW
authors.lastname: Rha
authors.forename: Chong Jin
authors.initials: CJ
authors.lastname: Kim
authors.forename: Donghoon
authors.initials: D
authors.lastname: Choi
authors.forename: Yang Soo
authors.initials: YS
authors.lastname: Jang
authors.forename: Junghan
authors.initials: J
authors.lastname: Yoon
authors.forename: Wook Sung
authors.initials: WS
authors.lastname: Chung
authors.forename: Jeong Gwan
authors.initials: JG
authors.lastname: Cho
authors.forename: Ki Bae
authors.initials: KB
authors.lastname: Seung
authors.forename: Seung Jung
authors.initials: SJ
authors.lastname: Park
mesh_terms: D000367:Age Factors; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000473:pathology / Q000628:therapy; D011446:Prospective Studies; D015912:Thrombolytic Therapy / Q000379:methods*
chemical_list: D005343:Fibrinolytic Agents