Early revascularization and long-term mortality in high-risk patients with non-ST-elevation myocardial infarction. The CARDIOCHUS-HUSJ registry.
Rev Esp Cardiol (Engl Ed)
; 73(1): 35-42, 2020 Jan.
Article
em En, Es
| MEDLINE
| ID: mdl-31122784
INTRODUCTION AND OBJECTIVES: This study sought to analyze the association of early coronary angiography with all-cause mortality and cardiovascular mortality in patients with non-ST-segment elevation acute coronary syndrome (NSTEACS) using a large contemporary cohort of patients with NSTEACS from 2 Spanish tertiary hospitals. METHODS: This retrospective observational study included 5673 consecutive NSTEACS patients from 2 Spanish hospitals between 2005 and 2016. We performed propensity score matching to obtain a well-balanced subset of patients with the same probability of undergoing an early strategy, resulting in 3780 patients. Survival analyses were performed by Cox regression models once proportional risk test were verified. RESULTS: Among the study participants, only 2087 patients (40.9%) underwent early invasive coronary angiography. The median follow-up was 59.0 months [interquartile range, 25.0-80.0 months]. All-cause mortality was 19.0%, cardiovascular mortality was 12.8%, and 51.1% patients experienced at least 1 major cardiovascular adverse event in the follow-up. After propensity score matching, the early strategy was associated with significantly lower mortality (hazard ratio: 0.79; 95% confidence interval 0.62-0.98) in high-risk NSTEACS patients. The darly strategy showed a nonsignificant inverse tendency in patients with GRACE score <140. CONCLUSIONS: In high-risk (GRACE score≥ 140) NSTEACS patients in a contemporary real-world registry, early coronary angiography (first 24hours after hospital admission) may be associated with reduced all-cause mortality and cardiovascular mortality at long-term follow-up.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Sistema de Registros
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Pontuação de Propensão
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Intervenção Coronária Percutânea
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Infarto do Miocárdio sem Supradesnível do Segmento ST
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Humans
País/Região como assunto:
Europa
Idioma:
En
/
Es
Ano de publicação:
2020
Tipo de documento:
Article