Abstract
Introduction: The non-ST elevation acute coronary syndrome (NSTE-ACS) account for more than 50% of the total number of patients with ACS. The mortality rates after NSTEMI are not significantly different when compared with patients with ST-segment elevation myocardial infarction. Aim: The aim of the present study was to investigate whether the assessment of clinical, laboratory and instrumental data during hospital stay provide any additional independent information in predicting the 3-year major cardiac events after NSTE-ACS. Methods: We observed 490 consecutive patients, who were admitted to the emergency cardiology department with NSTE-ACS. The patients' baseline characteristics, blood analysis, left ventricle (LV) and renal function data were assessed and analyzed. The median follow‑up time was 36 months. The endpoint was cardiovascular death. Results: The results of our study show that the risk of cardiovascular death during the three years follow-up after multivariate adjustment increases with older age (> 64 years), history of diabetes, prior myocardial infarction and history of angina pectoris, lower ejection fraction (<50%), degree of myocardial hypertrophy (the thickness of the interventricular septum >1.25 mm) of the LV and the degree of diastolic dysfunction (E-wave deceleration time (DT) < 150 ms), silent myocardial ischemia during first 24-hours, high pulse pressure on Day 1 (>49 mm Hg), glucose level > 7.5 mmol/l on admission and moderate kidney dysfunction (CrCl <60 ml/min). Conclusion: In patients with NSTE-ACS, we report the cardiovascular death risk factors within the 3-year follow-up period in the present study. We thus conclude that it is important to identify the patients with high risk of future cardiovascular complications.
Highlights
IntroductionThe non-ST elevation-acute coronary syndrome (NSTE-ACS) accounts for more than 50% of the total number of patients with ACS
Results of our study show that the risk of cardiovascular death during 3-year follow-up after multivariate adjustment increases with older age (>64 years), history of diabetes, prior myocardial infarction (MI), and history of angina pectoris [Figure 1]
The results of this study showed that older age, history of MI, previously diagnosed angina pectoris, diabetes, systolic dysfunction, heart rate variability (HRV) abnormality, elevated mean pulse blood pressure (BP) and blood glucose findings at the time of hospital admission, and lower CrCl findings were the main factors significantly associated with an adverse long-term prognosis following hospital discharge for patients with NSTE-ACS after multivariate adjustment for the demographic characteristics, comorbidities, and hospital complications
Summary
The non-ST elevation-acute coronary syndrome (NSTE-ACS) accounts for more than 50% of the total number of patients with ACS. Conclusion: In patients with NSTE-ACS, we report the cardiovascular death risk factors within the 3-year follow-up period in the present study. Mortality rates after AMI have decreased over the past decades but differ between ST-segment elevation MI (STEMI) and non-STEMI (NSTEMI) patients.[4] Data from randomized trials have shown that hospitalized patients with NSTEMI have a lower risk of death during the 1st few weeks after MI whereas are at the higher risk for cardiovascular outcomes over the long-term follow-up than those with STEMI.[5,6]. Among patients with NSTE-ACS, which includes NSTEMI and unstable angina (UA), risk stratification begins soon after admission to detect patients at high risk during the early
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