Mortality following non-ST elevation acute coronary syndrome: 4 years follow-up of the PRAIS UK Registry (Prospective Registry of Acute Ischaemic Syndromes in the UK)

被引:38
作者
Taneja, AK
Collinson, J
Flather, MD
Bakhai, A
de Arenaza, DP
Wang, D
Adgey, J
Fox, KAA
机构
[1] Royal Brompton & Harefield NHS Trust, Clin Trials & Evaluat Unit, London SW3 6NP, England
[2] Univ London Imperial Coll Sci & Technol, Sch Med, Natl Heart & Lung Inst, London, England
[3] Hosp Italiano Buenos Aires, Buenos Aires, DF, Argentina
[4] London Sch Hyg & Trop Med, Med Stat Unit, London WC1, England
[5] Royal Victoria Hosp, Belfast BT12 6BA, Antrim, North Ireland
[6] Royal Infirm, Edinburgh, Midlothian, Scotland
关键词
long term follow up; non-ST acute coronary syndrome; causes of mortality; risk factors and prognosis;
D O I
10.1016/j.ehj.2004.08.009
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aim To present information on tong-term prognosis and risk factors following an admission with non-ST elevation acute coronary syndrome. Methods A cohort of 653 patients was followed for mortality and causes of death using data from the UK Office of National Statistics (ONS). Cox proportional hazards model was used to identify the prognostic factors. Results Overall survival at a maximum follow-up of 45 months was 77.8% (95% CI 74.1-81.1%). Seventy-three per cent of the deaths were clearly due to a cardiovascular cause. Age, mate gender, heart failure, ST depression or bundle branch block were all associated with higher short- and long-term risk. Taking aspirin or having a revascularization procedure, over the period of six months following initial hospitalisation were both associated with a tower tong-term risk. Conclusion Non-ST elevation acute coronary syndromes carry a high risk of death over a 4-year period. Conventional risk factors can predict both short- and long-term risk. More invasive management and the use of evidence-based therapies appear to be associated with a lower risk. (C) 2004 Published by Elsevier Ltd on behalf of The European Society of Cardiology.
引用
收藏
页码:2013 / 2018
页数:6
相关论文
共 23 条
[1]   Rationale and design of the GRACE (Global Registry of Acute Coronary Events) Project:: A multinational registry of patients hospitalized with acute coronary syndromes [J].
Agnelli, G ;
Avezum, A ;
Brieger, D ;
Budaj, A ;
Cannon, CP ;
Goldberg, RJ ;
Goodman, S ;
Gulba, DC ;
Granger, C ;
Kennelly, BM ;
Gurfinkel, E ;
López-Sendón, J ;
Klein, W ;
Montalescot, G ;
Van de Werf, F .
AMERICAN HEART JOURNAL, 2001, 141 (02) :190-199
[2]   The TIMI risk score for unstable angina/non-ST elevation MI - A method for prognostication and therapeutic decision making [J].
Antman, EM ;
Cohen, M ;
Bernink, PJLM ;
McCabe, CH ;
Horacek, T ;
Papuchis, G ;
Mautner, B ;
Corbalan, R ;
Radley, D ;
Braunwald, E .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2000, 284 (07) :835-842
[3]   ISIS-2: 10 year survival among patients with suspected acute myocardial infarction in randomised comparison of intravenous streptokinase, oral aspirin, both, or neither [J].
Baigent, C ;
Collins, R ;
Appleby, P ;
Parish, S ;
Sleight, P ;
Peto, R .
BMJ-BRITISH MEDICAL JOURNAL, 1998, 316 (7141) :1337-1343
[4]   National economic impact of tirofiban for unstable angina and myocardial infarction without ST elevation; example from the United Kingdom [J].
Bakhai, A ;
Flather, MD ;
Collinson, JR ;
Stevens, W ;
Normand, C ;
Alemao, E ;
Itzler, R ;
Ben-Joseph, R .
INTERNATIONAL JOURNAL OF CARDIOLOGY, 2003, 91 (2-3) :163-172
[5]   Management of acute coronary syndromes in patients presenting without persistent ST-segment elevation [J].
Bertrand, ME ;
Simoons, ML ;
Fox, KAA ;
Wallentin, LC ;
Hamm, CW ;
McFadden, E ;
De Feyter, PJ ;
Specchia, G ;
Ruzyllo, W .
EUROPEAN HEART JOURNAL, 2002, 23 (23) :1809-1840
[6]   Management of acute coronary syndromes:: acute coronary syndromes without persistent ST segment elevation -: Recommendations of the Task Force of the European Society of Cardiology [J].
Bertrand, ME ;
Simoons, ML ;
Fox, KAA ;
Wallentin, LC ;
Hamm, CW ;
McFadden, E ;
De Feyter, PJ ;
Specchia, G ;
Ruzyllo, W .
EUROPEAN HEART JOURNAL, 2000, 21 (17) :1406-1432
[7]   ACC/AHA guidelines for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction: Executive summary and recommendations - A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients with Unstable Angina) [J].
Braunwald, E ;
Antman, EM ;
Beasley, JW ;
Califf, RM ;
Cheitlin, MD ;
Hochman, JS ;
Jones, RH ;
Kereiakes, D ;
Kupersmith, J ;
Levin, TN ;
Pepine, CJ ;
Schaeffer, JW ;
Smith, EE ;
Steward, DE ;
Theroux, P ;
Gibbons, RJ ;
Alpert, JS ;
Eagle, KA ;
Faxon, DP ;
Fuster, V ;
Gardner, TJ ;
Gregoratos, G ;
Russell, RO ;
Smith, SC .
CIRCULATION, 2000, 102 (10) :1193-1209
[8]   ACC/AHA guideline update for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction-2002: Summary article - A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients With Unstable Angina) [J].
Braunwald, E ;
Antman, EM ;
Beasley, JW ;
Califf, RM ;
Cheitlin, MD ;
Hochman, JS ;
Jones, RH ;
Kereiakes, D ;
Kupersmith, J ;
Levin, TN ;
Pepine, CJ ;
Schaeffer, JW ;
Smith, EE ;
Steward, DE ;
Theroux, P ;
Gibbons, RJ ;
Alpert, JS ;
Faxon, DP ;
Fuster, V ;
Gregoratos, G ;
Hiratzka, LF ;
Jacobs, AK ;
Smith, SC .
CIRCULATION, 2002, 106 (14) :1893-1900
[9]   Clinical outcomes, risk stratification and practice patterns of unstable angina and myocardial infarction without ST elevation: Prospective Registry of Acute Ischaemic Syndromes in the UK (PRAIS-UK) [J].
Collinson, J ;
Flather, MD ;
Fox, KAA ;
Findlay, I ;
Rodrigues, E ;
Dooley, P ;
Ludman, P ;
Adgey, J ;
Bowker, TJ ;
Mattu, P .
EUROPEAN HEART JOURNAL, 2000, 21 (17) :1450-1457
[10]   A validated prediction model for all forms of acute coronary syndrome - Estimating the risk of 6-month postdischarge death in an international registry [J].
Eagle, KA ;
Lim, MJ ;
Dabbous, OH ;
Pieper, KS ;
Goldberg, RJ ;
Van de Werf, F ;
Goodman, SG ;
Granger, CB ;
Steg, PG ;
Gore, JM ;
Budaj, A ;
Avezum, A ;
Flather, MD ;
Fox, KAA .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2004, 291 (22) :2727-2733