title: Outcomes in patients with acute and stable coronary syndromes; insights from the prospective NOBORI-2 study.
abstract: BACKGROUND
  Contemporary data remains limited regarding mortality and major adverse cardiac events (MACE) outcomes in patients undergoing PCI for different manifestations of coronary artery disease.
  
  
  OBJECTIVE
  We evaluated mortality and MACE outcomes in patients treated with PCI for STEMI (ST-elevation myocardial infarction), NSTEMI (non ST-elevation myocardial infarction) and stable angina through analysis of data derived from the Nobori-2 study.
  
  
  METHODS
  Clinical endpoints were cardiac mortality and MACE (a composite of cardiac death, myocardial infarction and target vessel revascularization).
  
  
  RESULTS
  1909 patients who underwent PCI were studied; 1332 with stable angina, 248 with STEMI and 329 with NSTEMI. Age-adjusted Charlson co-morbidity index was greatest in the NSTEMI cohort (3.78±1.91) and lowest in the stable angina cohort (3.00±1.69); P<0.0001. Following Cox multivariate analysis cardiac mortality was independently worse in the NSTEMI vs the stable angina cohort (HR 2.31 (1.10-4.87), p = 0.028) but not significantly different for STEMI vs stable angina cohort (HR 0.72 (0.16-3.19), p = 0.67). Similar observations were recorded for MACE (<180 days) (NSTEMI vs stable angina: HR 2.34 (1.21-4.55), p = 0.012; STEMI vs stable angina: HR 2.19 (0.97-4.98), p = 0.061.
  
  
  CONCLUSIONS
  The longer-term Cardiac mortality and MACE were significantly worse for patients following PCI for NSTEMI even after adjustment of clinical demographics and Charlson co-morbidity index whilst the longer-term prognosis of patients following PCI STEMI was favorable, with similar outcomes as those patients with stable angina following PCI.
authors.affiliation: Manchester Heart Centre, Manchester Royal Infirmary, Manchester, United Kingdom.
authors.forename: Farzin
authors.initials: F
authors.lastname: Fath-Ordoubadi
authors.affiliation: SBD Analytics, Hertstraat, Bekkevoort, Belgium.
authors.forename: Erik
authors.initials: E
authors.lastname: Spaepen
authors.affiliation: Manchester Heart Centre, Manchester Royal Infirmary, Manchester, United Kingdom.
authors.forename: Magdi
authors.initials: M
authors.lastname: El-Omar
authors.affiliation: Manchester Heart Centre, Manchester Royal Infirmary, Manchester, United Kingdom.
authors.forename: Douglas G
authors.initials: DG
authors.lastname: Fraser
authors.affiliation: Manchester Heart Centre, Manchester Royal Infirmary, Manchester, United Kingdom.
authors.forename: Muhammad A
authors.initials: MA
authors.lastname: Khan
authors.affiliation: Manchester Heart Centre, Manchester Royal Infirmary, Manchester, United Kingdom.
authors.forename: Ludwig
authors.initials: L
authors.lastname: Neyses
authors.affiliation: Division of Cardiology, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Gian B
authors.initials: GB
authors.lastname: Danzi
authors.affiliation: Department of Cardiology, Rambam Medical Center, Haifa, Israel.
authors.forename: Ariel
authors.initials: A
authors.lastname: Roguin
authors.affiliation: European Medical and Clinical Division, Terumo Europe, Leuven, Belgium.
authors.forename: Dragica
authors.initials: D
authors.lastname: Paunovic
authors.affiliation: Manchester Heart Centre, Manchester Royal Infirmary, Manchester, United Kingdom ; Cardiovascular Institute, University of Manchester, Manchester, United Kingdom.
authors.forename: Mamas A
authors.initials: MA
authors.lastname: Mamas
mesh_terms: D054058:Acute Coronary Syndrome / Q000628:therapy*; D000368:Aged; D060050:Angina, Stable / Q000628:therapy*; D003643:Death; D003710:Demography; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects; D016016:Proportional Hazards Models; D011446:Prospective Studies; D016896:Treatment Outcome