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.
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.
Jeong
Hae Chang
HC
Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea.
Ahn
Youngkeun
Y
Jeong
Myung Ho
MH
Chae
Shung Chull
SC
Hur
Seung Ho
SH
Hong
Taek Jong
TJ
Kim
Young Jo
YJ
Seong
In Whan
IW
Chae
Jei Keon
JK
Rhew
Jay Young
JY
Chae
In Ho
IH
Cho
Myeong Chan
MC
Bae
Jang Ho
JH
Rha
Seung Woon
SW
Kim
Chong Jin
CJ
Choi
Donghoon
D
Jang
Yang Soo
YS
Yoon
Junghan
J
Chung
Wook Sung
WS
Cho
Jeong Gwan
JG
Seung
Ki Bae
KB
Park
Seung Jung
SJ
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*
D005343:Fibrinolytic Agents