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. 2020 Mar;16(1):41-48.
doi: 10.5114/aic.2020.93911. Epub 2020 Apr 3.

The progress in outcomes of the management of patients with non-ST-segment elevation myocardial infarction between 2005 and 2014 in Poland - a propensity score matching analysis from the PL-ACS registry

Łukasz Piątek  1   2 , Agnieszka Janion-Sadowska  2 , Karolina Piątek  2 , Łukasz Zandecki  1   2 , Jacek Kurzawski  2 , Mariusz Gąsior  3 , Marcin Sadowski  1   4
Affiliations

The progress in outcomes of the management of patients with non-ST-segment elevation myocardial infarction between 2005 and 2014 in Poland - a propensity score matching analysis from the PL-ACS registry

Łukasz Piątek et al. Postepy Kardiol Interwencyjnej. 2020 Mar.

Abstract

Introduction: Dynamic changes both in clinical profile and treatment strategy of non ST-segment elevation myocardial infarction (NSTEMI) patients have been observed recently. The exact impact of them on prognosis in a wide national population remains unclear.

Aim: To evaluate the impact of treatment advances between 2005 and 2014 on the outcomes of NSTEMI cases.

Material and methods: NSTEMI patients from the Polish Registry of Acute Coronary Syndromes (PL-ACS) were included to the analysis. The mortality rate in a hospital observation as well as in 12-month follow-up was evaluated.

Results: The frequency of diabetes, hypertension, prior coronary artery interventions (especially percutaneous coronary intervention) raised. A frequency of invasive procedures increased remarkably (coronary angiography from 35.8% to 90.7%; p < 0.05 and percutaneous coronary intervention from 25.7% to 63.6%; p < 0.05). The usage of P2Y12 - inhibitors raised substantially from 56% to 93%; p < 0.05. In-hospital mortality decreased by fifty percent (in women from 6.6% to 3.3%; p < 0.001 and in men from 4.9% to 2.5%; p < 0.001, respectively). Similarly, 12-month mortality decreased up to one third (in women from 21.6% to 15.1%; p < 0.001 and in men from 17.8% to 12.8%; p < 0.001, respectively). Invasive strategy appeared to be the strongest factor decreasing mortality. Into in-hospital observation it reduces triple mortality risk whereas in 12-month follow up twice. Using propensity score matching analysis the impact of the treatment improvements on relative risk reduction was estimated on over 60%.

Conclusions: In last decade the outcomes of NSTEMI in Poland improved substantially. The predominant impact on it had a routine invasive strategy.

Keywords: invasive treatment; non ST-segment elevation myocardial infarction; outcomes; propensity score matching.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Impact of the treatment improvements and clinical profile changes on mortality reduction in NSTEMI in 2005–2014
See this image and copyright information in PMC

References

    1. Gierlotka M, Zdrojewski T, Wojtyniak B, et al. Incidence, treatment, in-hospital mortality and one-year outcomes of acute myocardial infarction in Poland in 2009-2012 – nationwide AMI-PL database. Kardiol Pol. 2015;73:142–58. - PubMed
    1. Gierlotka M, Gąsior M, Wilczek K, et al. Temporal trends in the treatment and outcomes of patients with non-ST-segment elevation myocardial infarction in Poland from 2004-2010 (from the Polish Registry of Acute Coronary Syndromes) Am J Cardiol. 2012;109:779–86. - PubMed
    1. Puymirat E, Simon T, Cayla G, et al. Acute myocardial infarction: changes in patient characteristics, management, and 6-month outcomes over a period of 20 years in the FAST-MI Program (French Registry of Acute ST-Elevation or Non-ST-Elevation Myocardial Infarction) 1995 to 2015. Circulation. 2017;136:1908–19. - PubMed
    1. Khera S, Kolte D, Aronow WS, et al. Non-ST-elevation myocardial infarction in the United States: contemporary trends in incidence, utilization of the early invasive strategy, and in-hospital outcomes. Am Heart Assoc. 2014;3:e000995. - PMC - PubMed
    1. Mårtensson S, Gyrd-Hansen D, Prescott E, et al. Trends in time to invasive examination and treatment from 2001 to 2009 in patients admitted first time with non-ST elevation myocardial infarction or unstable angina in Denmark. BMJ Open. 2014;4:e004052. - PMC - PubMed

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