In-hospital outcome according to the initial management and the "thrombolysis in myocardial infarction risk score" of acute non-ST segment elevation myocardial infarction

Hae Chang Jeong, Ho Jeong Myung, Keun Ahn Young, Chull Chae Sung, Jo Kim Young, Ho Hur Seung, Hoon Choi Dong, Han Yoon Jung, Keon Chae Jei, Il Kim Doo, Kwon Koo Bon, Yong Hwang Jin, Kyu Oh Seok, Sik Kim Kee, Tae Jeong Kyung, Jin Kim Chong, Sung Chung Wook, Soo Jang Yang, Chull Chae Shung, Hyun Kim JongWhan Seong In, Jong Hong Taek, Young Rhew Jae, Ho Chae In, Ok Kim Byung, Yong Lee Myoung, Chan Cho Myeong, Hee Lee Nae, Tae Jeong Kyoung, Jea Tahk Seung, Ho Bae Jang, Woon Rha Seung, Soo Park Keum, Rok Han Kyoo, Hoon Ahn Tae, Hyun Kim Moo, Bae Seung Ki, Young Yang Ju, Yun Rhim Chong, Cheol Gwon Hyeon, Wook Park Seong, Youp Koh Young, Jae Joo Seung, Joong Kim Soo, Kyu Jin Dong, Man Cho Jin, Gwan Cho Jeong, Jung Park Seung

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Abstract

Background and Objectives: The current guidelines recommend an early invasive strategy for patients suffering with non-ST segment elevation myocardial infarction (NSTEMI). However, there is still debate about the timing of revascularization in patients with NSTEMI. To analyze the clinical efficacy of the timing of revascularization, we compared the in-hospital clinical outcome of NSTEMI patients from the Korea Acute Myocardial Infarction Registry (KAMIR) between the early and selective invasive therapeutic groups. Subjects and Methods: Between Nov. 2005 and Apr. 2007, 2762 acute NSTEMI patients (mean age=64.6 ± 12.8 years, 1847 males) were enrolled in the KAMIR. The therapeutic strategy of NSTEMI was categorized into early invasive treatment (within 48 hours, Group I mean age: 63.1 ± 13.1 years, 1085 males) and selective invasive treatment (Group II mean age: 66.5 ± 12.1 years, 762 males). The initial clinical status and the in-hospital mortality and morbidity rate were compared between these two groups. The in-hospital outcomes were also compared between the two groups according to each level of the Thrombolysis In Myocardial Infarction (TIMI) risk score. Results: There were significant differences in the mortality and morbidity rate between the groups (6.5% vs. 10.3%, respectively, p<0.001). According to TIMI risk score, there were no significant differences of mortality and morbidity for the low to moderate risk patients (5.3% vs. 7.8%, respectively, p=0.123 for the risk score 0-2, 6.4% vs. 8.7%, p=0.139 for the risk score 3-4). Conclusion: Early invasive treatment improves the hospital outcome for the high-risk NSTEMI patients. The use of abciximab, a low ejection fraction, a high Killip class, a high TIMI risk score and old age are the predictive factors of in-hospital mortality and morbidity.

Original languageEnglish
Pages (from-to)550-558
Number of pages9
JournalKorean Circulation Journal
Volume37
Issue number11
DOIs
Publication statusPublished - 2007 Nov

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

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    Jeong, H. C., Myung, H. J., Young, K. A., Sung, C. C., Young, J. K., Seung, H. H., Dong, H. C., Jung, H. Y., Jei, K. C., Doo, I. K., Bon, K. K., Jin, Y. H., Seok, K. O., Kee, S. K., Kyung, T. J., Chong, J. K., Wook, S. C., Yang, S. J., Shung, C. C., ... Seung, J. P. (2007). In-hospital outcome according to the initial management and the "thrombolysis in myocardial infarction risk score" of acute non-ST segment elevation myocardial infarction. Korean Circulation Journal, 37(11), 550-558. https://doi.org/10.4070/kcj.2007.37.11.550