Late Consequences of Acute Coronary Syndromes: Global Registry of Acute Coronary Events (GRACE)Follow-up
Am. j. med
; 29(0): 1-10, 2014. ilus
Artigo
em Inglês
| Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP
| ID: biblio-1059513
Biblioteca responsável:
BR79.1
Localização: BR79.1
ABSTRACT
PURPOSE:
Short-term outcomes have been well characterized in acute coronary syndromes; however,longer-term follow-up for the entire spectrum of these patients, including ST-segment-elevation myocardialinfarction, non-ST-segment-elevation myocardial infarction, and unstable angina, is more limited. Therefore,we describe the longer-term outcomes, procedures, and medication use in Global Registry of AcuteCoronary Events (GRACE) hospital survivors undergoing 6-month and 2-year follow-up, and the performanceof the discharge GRACE risk score in predicting 2-year mortality.METHODS:
Between 1999 and 2007, 70,395 patients with a suspected acute coronary syndrome wereenrolled. In 2004, 2-year prospective follow-up was undertaken in those with a discharge acute coronarysyndrome diagnosis in 57 sites.RESULTS:
From 2004 to 2007, 19,122 (87.2%) patients underwent follow-up; by 2 years postdischarge,14.3% underwent angiography, 8.7% percutaneous coronary intervention, 2.0% coronary bypass surgery,and 24.2% were re-hospitalized. In patients with 2-year follow-up, acetylsalicylic acid (88.7%), betablocker(80.4%), renin-angiotensin system inhibitor (69.8%), and statin (80.2%) therapy was used. Heartfailure occurred in 6.3%, (re)infarction in 4.4%, and death in 7.1%. Discharge-to-6-month GRACE riskscore was highly predictive of all-cause mortality at 2 years (c-statistic 0.80).CONCLUSION:
In this large multinational cohort of acute coronary syndrome patients, there were importantlater adverse consequences, including frequent morbidity and mortality. These findings were seen in thecontext of additional coronary procedures and despite continued use of evidence-based therapies in a highproportion of patients. The discriminative accuracy of the GRACE risk score in hospital survivors forpredicting longer-term mortality was maintained.
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Coleções:
Bases de dados nacionais
/
Brasil
Base de dados:
Sec. Est. Saúde SP
/
SESSP-IDPCPROD
Assunto principal:
Síndrome Coronariana Aguda
/
Infarto do Miocárdio
/
Revascularização Miocárdica
Tipo de estudo:
Estudo prognóstico
Idioma:
Inglês
Revista:
Am. j. med
Ano de publicação:
2014
Tipo de documento:
Artigo
Instituição/País de afiliação:
Canadian Heart Research Centre/CA
/
Centre Hospitalier Bichat-Claude Bernard/FR
/
Centre Hospitalier Universitaire Pitié-Salpêtrière/FR
/
Concord Hospital/AU
/
Duke University Medical Center/GB
/
Grochowski Hospital/PL
/
Hoag Memorial Hospital Presbyterian/US
/
ICYCC Favaloro Foundation/AR
/
Instituto Dante Pazzanese de Cardiologia/BR
/
KKO St. Marien Hospital/DE