Early- and late-term clinical outcome and their predictors in patients with ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction

Hyun Woong Park, Chang Hwan Yoon, Si Hyuck Kang, Dong Ju Choi, Hyo Soo Kim, Myeong Chan Cho, Young Jo Kim, Shung Chull Chae, Junghan Yoon, Hyeon Cheol Gwon, Young Keun Ahn, Myung Ho Jeong

Research output: Contribution to journalArticle

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Abstract

Backgrounds The disparity between ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) remains controversial. We compared clinical outcomes and prognostic factors between STEMI and NSTEMI using large-scale registry data. Methods We recruited 28,421 patients with STEMI (n = 16,607) and NSTEMI (n = 11,814) between November 2005 and April 2010 from a nationwide registry in Korea. We performed landmark analysis of cardiac death, recurrent acute myocardial infarction (re-AMI), revascularization, and major adverse cardiac events (MACE) at 30 days (early term) and 1 year (late term) after admission. Results Patients with NSTEMI had a greater number of co-morbidities than STEMI patients. Early term MACE (6.9% vs. 4.5%, p < 0.001) and cardiac death (6.1% vs. 3.7%, p < 0.001) were higher in STEMI patients. However, late-term MACE (8.0% vs. 9.1%, p = 0.007), cardiac death (1.9% vs. 2.6%, p = 0.001), and re-AMI (0.6% vs. 1.3%, p < 0.001) were lower in the STEMI group. The independent predictors of cardiac death were old age, renal dysfunction, LV dysfunction, Killip class, post-thrombolysis in myocardial infarction (TIMI) flow, and major bleeding in both groups. Female gender, previous ischemic heart disease, diabetes, current smoking, multivessel disease, and body mass index were MI type- or time-dependent predictors. Conclusion The STEMI group displayed poor early term clinical outcome, whereas the NSTEMI group displayed poor late-term clinical outcome. The STEMI and NSTEMI groups had different predictor profiles for cardiac death, suggesting that different strategies are required for improving the late-term outcome of STEMI and NSTEMI patients.

Original languageEnglish
Pages (from-to)254-261
Number of pages8
JournalInternational Journal of Cardiology
Volume169
Issue number4
DOIs
Publication statusPublished - 2013 Nov 15

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Myocardial Infarction
Registries
ST Elevation Myocardial Infarction
Non-ST Elevated Myocardial Infarction
Myocardial Revascularization
Korea
Myocardial Ischemia
Body Mass Index
Smoking
Hemorrhage
Morbidity
Kidney

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Park, Hyun Woong ; Yoon, Chang Hwan ; Kang, Si Hyuck ; Choi, Dong Ju ; Kim, Hyo Soo ; Cho, Myeong Chan ; Kim, Young Jo ; Chae, Shung Chull ; Yoon, Junghan ; Gwon, Hyeon Cheol ; Ahn, Young Keun ; Jeong, Myung Ho. / Early- and late-term clinical outcome and their predictors in patients with ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction. In: International Journal of Cardiology. 2013 ; Vol. 169, No. 4. pp. 254-261.
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title = "Early- and late-term clinical outcome and their predictors in patients with ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction",
abstract = "Backgrounds The disparity between ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) remains controversial. We compared clinical outcomes and prognostic factors between STEMI and NSTEMI using large-scale registry data. Methods We recruited 28,421 patients with STEMI (n = 16,607) and NSTEMI (n = 11,814) between November 2005 and April 2010 from a nationwide registry in Korea. We performed landmark analysis of cardiac death, recurrent acute myocardial infarction (re-AMI), revascularization, and major adverse cardiac events (MACE) at 30 days (early term) and 1 year (late term) after admission. Results Patients with NSTEMI had a greater number of co-morbidities than STEMI patients. Early term MACE (6.9{\%} vs. 4.5{\%}, p < 0.001) and cardiac death (6.1{\%} vs. 3.7{\%}, p < 0.001) were higher in STEMI patients. However, late-term MACE (8.0{\%} vs. 9.1{\%}, p = 0.007), cardiac death (1.9{\%} vs. 2.6{\%}, p = 0.001), and re-AMI (0.6{\%} vs. 1.3{\%}, p < 0.001) were lower in the STEMI group. The independent predictors of cardiac death were old age, renal dysfunction, LV dysfunction, Killip class, post-thrombolysis in myocardial infarction (TIMI) flow, and major bleeding in both groups. Female gender, previous ischemic heart disease, diabetes, current smoking, multivessel disease, and body mass index were MI type- or time-dependent predictors. Conclusion The STEMI group displayed poor early term clinical outcome, whereas the NSTEMI group displayed poor late-term clinical outcome. The STEMI and NSTEMI groups had different predictor profiles for cardiac death, suggesting that different strategies are required for improving the late-term outcome of STEMI and NSTEMI patients.",
author = "Park, {Hyun Woong} and Yoon, {Chang Hwan} and Kang, {Si Hyuck} and Choi, {Dong Ju} and Kim, {Hyo Soo} and Cho, {Myeong Chan} and Kim, {Young Jo} and Chae, {Shung Chull} and Junghan Yoon and Gwon, {Hyeon Cheol} and Ahn, {Young Keun} and Jeong, {Myung Ho}",
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Early- and late-term clinical outcome and their predictors in patients with ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction. / Park, Hyun Woong; Yoon, Chang Hwan; Kang, Si Hyuck; Choi, Dong Ju; Kim, Hyo Soo; Cho, Myeong Chan; Kim, Young Jo; Chae, Shung Chull; Yoon, Junghan; Gwon, Hyeon Cheol; Ahn, Young Keun; Jeong, Myung Ho.

In: International Journal of Cardiology, Vol. 169, No. 4, 15.11.2013, p. 254-261.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Early- and late-term clinical outcome and their predictors in patients with ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction

AU - Park, Hyun Woong

AU - Yoon, Chang Hwan

AU - Kang, Si Hyuck

AU - Choi, Dong Ju

AU - Kim, Hyo Soo

AU - Cho, Myeong Chan

AU - Kim, Young Jo

AU - Chae, Shung Chull

AU - Yoon, Junghan

AU - Gwon, Hyeon Cheol

AU - Ahn, Young Keun

AU - Jeong, Myung Ho

PY - 2013/11/15

Y1 - 2013/11/15

N2 - Backgrounds The disparity between ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) remains controversial. We compared clinical outcomes and prognostic factors between STEMI and NSTEMI using large-scale registry data. Methods We recruited 28,421 patients with STEMI (n = 16,607) and NSTEMI (n = 11,814) between November 2005 and April 2010 from a nationwide registry in Korea. We performed landmark analysis of cardiac death, recurrent acute myocardial infarction (re-AMI), revascularization, and major adverse cardiac events (MACE) at 30 days (early term) and 1 year (late term) after admission. Results Patients with NSTEMI had a greater number of co-morbidities than STEMI patients. Early term MACE (6.9% vs. 4.5%, p < 0.001) and cardiac death (6.1% vs. 3.7%, p < 0.001) were higher in STEMI patients. However, late-term MACE (8.0% vs. 9.1%, p = 0.007), cardiac death (1.9% vs. 2.6%, p = 0.001), and re-AMI (0.6% vs. 1.3%, p < 0.001) were lower in the STEMI group. The independent predictors of cardiac death were old age, renal dysfunction, LV dysfunction, Killip class, post-thrombolysis in myocardial infarction (TIMI) flow, and major bleeding in both groups. Female gender, previous ischemic heart disease, diabetes, current smoking, multivessel disease, and body mass index were MI type- or time-dependent predictors. Conclusion The STEMI group displayed poor early term clinical outcome, whereas the NSTEMI group displayed poor late-term clinical outcome. The STEMI and NSTEMI groups had different predictor profiles for cardiac death, suggesting that different strategies are required for improving the late-term outcome of STEMI and NSTEMI patients.

AB - Backgrounds The disparity between ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) remains controversial. We compared clinical outcomes and prognostic factors between STEMI and NSTEMI using large-scale registry data. Methods We recruited 28,421 patients with STEMI (n = 16,607) and NSTEMI (n = 11,814) between November 2005 and April 2010 from a nationwide registry in Korea. We performed landmark analysis of cardiac death, recurrent acute myocardial infarction (re-AMI), revascularization, and major adverse cardiac events (MACE) at 30 days (early term) and 1 year (late term) after admission. Results Patients with NSTEMI had a greater number of co-morbidities than STEMI patients. Early term MACE (6.9% vs. 4.5%, p < 0.001) and cardiac death (6.1% vs. 3.7%, p < 0.001) were higher in STEMI patients. However, late-term MACE (8.0% vs. 9.1%, p = 0.007), cardiac death (1.9% vs. 2.6%, p = 0.001), and re-AMI (0.6% vs. 1.3%, p < 0.001) were lower in the STEMI group. The independent predictors of cardiac death were old age, renal dysfunction, LV dysfunction, Killip class, post-thrombolysis in myocardial infarction (TIMI) flow, and major bleeding in both groups. Female gender, previous ischemic heart disease, diabetes, current smoking, multivessel disease, and body mass index were MI type- or time-dependent predictors. Conclusion The STEMI group displayed poor early term clinical outcome, whereas the NSTEMI group displayed poor late-term clinical outcome. The STEMI and NSTEMI groups had different predictor profiles for cardiac death, suggesting that different strategies are required for improving the late-term outcome of STEMI and NSTEMI patients.

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