Early and late case fatality after hospitalization for acute coronary syndrome in France, 2010-2015.
Arch Cardiovasc Dis
; 112(12): 754-764, 2019 Dec.
Article
em En
| MEDLINE
| ID: mdl-31718932
ABSTRACT
BACKGROUND:
Case-fatality data for acute coronary syndromes (ACS) are scarce in unselected French patients.AIMS:
To analyse early and late case-fatality rates in patients with ACS in France, case fatality determinants and time trends between 2010 and 2015.METHODS:
For each year from 2010 to 2015, all patients hospitalized for ACS in France and aged>18 years were selected. Multivariable Cox models were used to assess determinants of case fatality at 3 days, 4-30 days and 31-365 days after hospital admission.RESULTS:
In 2015, cumulative 3-day, 30-day and 1-year case-fatality rates were, respectively, 2.0%, 5.1% and 11.1% for all patients with ACS, and 3.9%, 8.5% and 13.8% for those with ST-segment elevation myocardial infarction (STEMI). Admission through the emergency department was associated with a higher risk of death, particularly at 3 days. Female sex was associated with higher case-fatality rates at 3 days, but with lower case-fatality rates at 31-365 days. Social deprivation was associated with higher case-fatality rates for all periods for all patients with ACS. A significant decrease was found between 2010 and 2015 in case-fatality rates at 31-365 days, particularly for patients with STEMI; this time trend was no longer significant after additional adjustment for hospital management.CONCLUSIONS:
Case fatality up to 1 year after hospitalization for ACS was non-negligible, highlighting the need to ensure better follow-up after the acute stage, particularly in the most deprived patients. As hospital admission through the emergency department still occurs frequently, health policy should promote a national campaign to increase the awareness and preparedness of the general population regarding ACS. Finally, our results suggest that women need specific attention early after the index event.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Síndrome Coronariana Aguda
/
Hospitalização
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
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Adult
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Aged
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Aged80
/
Female
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Humans
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Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Arch Cardiovasc Dis
Assunto da revista:
ANGIOLOGIA
/
CARDIOLOGIA
Ano de publicação:
2019
Tipo de documento:
Article