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 language | English |
|---|---|
| Pages (from-to) | 254-261 |
| Number of pages | 8 |
| Journal | International Journal of Cardiology |
| Volume | 169 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 2013 Nov 15 |
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All Science Journal Classification (ASJC) codes
- Cardiology and Cardiovascular Medicine
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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 journal › Article
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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U2 - 10.1016/j.ijcard.2013.08.132
DO - 10.1016/j.ijcard.2013.08.132
M3 - Article
C2 - 24071385
AN - SCOPUS:84887453953
VL - 169
SP - 254
EP - 261
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
IS - 4
ER -