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[Clinical characteristics, in-hospital outcomes and predictors of in-hospital mortality in patients with acute coronary syndromes without persistent ST-segment elevation assigned to early invasive treatment strategy].
Przegl Lek 2005; 62(5):265-9PL

Abstract

BACKGROUND

Early invasive strategy is one of alternative methods for management of acute coronary syndromes (ACS) without persistent ST-segment elevation.

HYPOTHESIS

The aim of the study was analysis of clinical characteristics, in-hospital outcome and factors of in-hospital mortality.

METHODS

The study group comprised 853 patients who were defined as high-risk, based on resting pain episodes within previous 24 hours, changes of ST-T segment in ECG, and elevated serum cardiac markers. All patients underwent coronary angiography followed by PCI (percutaneous coronary interventions) in 73.1% of patients. 16.7% were assigned to CABG (coronary artery bypass graft), 1.6% of patients underwent PCI and CABG and 8.6% of patients were treated conservatively.

RESULTS

Overall in-hospital mortality was 3%; 1.4% in the PCI group, 8.4% in the CABG group and 6.8% in conservatively treated patients. The independent risk factors of in-hospital deaths were: Braunwald's IIIC class angina (OR 7.8; 95%CI 3.6-12.37 p=0.004), recurrent angina after revascularization (OR 13.04; 95%CI 7.62-29.23 p=0.002), congestive heart failure (OR 11.45; 95%CI 8.01-18,38 p=0.00001) and evolving myocardial infarction with ST-segment elevation (OR 12.77; 95%CI 8.35-27.35 p=0.0001). Stent implantation was associated with decreased risk of in-hospital death (OR 0.12; 95%CI 0.07-0.41; p=0.003).

CONCLUSIONS

Early invasive strategy in patients with ACS without ST-segment elevation is efficacious method of treatment. Independent predictors of in-hospital deaths are: Braunwald's IIIC class angina, congestive heart failure, recurrent angina after revascularization, myocardial infarction complicating hospital course. Stent implantation improves in-hospital prognosis.

Authors+Show Affiliations

III Katedra i Oddział Kliniczny Kardiologii, Slaskiej Akademii Medycznej, Kierownik Kliniki. b.szygula@sccs.plNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

pol

PubMed ID

16334529

Citation

Szyguła-Jurkiewicz, Bozena, et al. "[Clinical Characteristics, In-hospital Outcomes and Predictors of In-hospital Mortality in Patients With Acute Coronary Syndromes Without Persistent ST-segment Elevation Assigned to Early Invasive Treatment Strategy]." Przeglad Lekarski, vol. 62, no. 5, 2005, pp. 265-9.
Szyguła-Jurkiewicz B, Wojnicz R, Trzeciak P, et al. [Clinical characteristics, in-hospital outcomes and predictors of in-hospital mortality in patients with acute coronary syndromes without persistent ST-segment elevation assigned to early invasive treatment strategy]. Prz Lek. 2005;62(5):265-9.
Szyguła-Jurkiewicz, B., Wojnicz, R., Trzeciak, P., Niklewski, T., Zembala, M., & Poloński, L. (2005). [Clinical characteristics, in-hospital outcomes and predictors of in-hospital mortality in patients with acute coronary syndromes without persistent ST-segment elevation assigned to early invasive treatment strategy]. Przeglad Lekarski, 62(5), pp. 265-9.
Szyguła-Jurkiewicz B, et al. [Clinical Characteristics, In-hospital Outcomes and Predictors of In-hospital Mortality in Patients With Acute Coronary Syndromes Without Persistent ST-segment Elevation Assigned to Early Invasive Treatment Strategy]. Prz Lek. 2005;62(5):265-9. PubMed PMID: 16334529.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Clinical characteristics, in-hospital outcomes and predictors of in-hospital mortality in patients with acute coronary syndromes without persistent ST-segment elevation assigned to early invasive treatment strategy]. AU - Szyguła-Jurkiewicz,Bozena, AU - Wojnicz,Romuald, AU - Trzeciak,Przemysław, AU - Niklewski,Tomasz, AU - Zembala,Marian, AU - Poloński,Lech, PY - 2005/12/13/pubmed PY - 2006/2/1/medline PY - 2005/12/13/entrez SP - 265 EP - 9 JF - Przeglad lekarski JO - Prz. Lek. VL - 62 IS - 5 N2 - BACKGROUND: Early invasive strategy is one of alternative methods for management of acute coronary syndromes (ACS) without persistent ST-segment elevation. HYPOTHESIS: The aim of the study was analysis of clinical characteristics, in-hospital outcome and factors of in-hospital mortality. METHODS: The study group comprised 853 patients who were defined as high-risk, based on resting pain episodes within previous 24 hours, changes of ST-T segment in ECG, and elevated serum cardiac markers. All patients underwent coronary angiography followed by PCI (percutaneous coronary interventions) in 73.1% of patients. 16.7% were assigned to CABG (coronary artery bypass graft), 1.6% of patients underwent PCI and CABG and 8.6% of patients were treated conservatively. RESULTS: Overall in-hospital mortality was 3%; 1.4% in the PCI group, 8.4% in the CABG group and 6.8% in conservatively treated patients. The independent risk factors of in-hospital deaths were: Braunwald's IIIC class angina (OR 7.8; 95%CI 3.6-12.37 p=0.004), recurrent angina after revascularization (OR 13.04; 95%CI 7.62-29.23 p=0.002), congestive heart failure (OR 11.45; 95%CI 8.01-18,38 p=0.00001) and evolving myocardial infarction with ST-segment elevation (OR 12.77; 95%CI 8.35-27.35 p=0.0001). Stent implantation was associated with decreased risk of in-hospital death (OR 0.12; 95%CI 0.07-0.41; p=0.003). CONCLUSIONS: Early invasive strategy in patients with ACS without ST-segment elevation is efficacious method of treatment. Independent predictors of in-hospital deaths are: Braunwald's IIIC class angina, congestive heart failure, recurrent angina after revascularization, myocardial infarction complicating hospital course. Stent implantation improves in-hospital prognosis. SN - 0033-2240 UR - https://www.unboundmedicine.com/medline/citation/16334529/[Clinical_characteristics_in_hospital_outcomes_and_predictors_of_in_hospital_mortality_in_patients_with_acute_coronary_syndromes_without_persistent_ST_segment_elevation_assigned_to_early_invasive_treatment_strategy]_ L2 - https://medlineplus.gov/coronaryarterybypasssurgery.html DB - PRIME DP - Unbound Medicine ER -