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. 2010 Jan;51(1):58-68.
doi: 10.3349/ymj.2010.51.1.58. Epub 2009 Dec 29.

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

Collaborators, Affiliations

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

Hae Chang Jeong et al. Yonsei Med J. 2010 Jan.

Erratum in

  • Yonsei Med J. 2010 May;51(3):478

Abstract

Purpose: 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).

Materials and 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.

Keywords: Myocardial infarction; TIMI risk score; invasive treatment; non-ST-segment elevation; prognosis.

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Conflict of interest statement

The authors have no financial conflicts of interest.

Figures

Fig. 1
Fig. 1
Primary end point (one-year major adverse cardiac events) according to the Thrombolysis In Myocardial Infarction (TIMI) risk score.
Fig. 2
Fig. 2
Estimated rates and relative risk of the composite primary end points of death from cardiac or non cardiac causes, recurrent myocardial infarction, target vessel or non-target vessel or target lesion revascularization at one year according to subgroups.

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