| Determinants and outcomes of coronary angiography after non-ST-segment elevation myocardial infarction. A cohort study of the Myocardial Ischaemia National Audit Project (MINAP). | |
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MedLine Citation:
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PMID: 19508971 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To investigate determinants of, and outcomes from, coronary angiography and intervention in patients with non-ST-segment elevation myocardial infarction (NSTEMI). DESIGN: Observational study. SETTING: 44 British hospitals with interventional facilities. PATIENTS: 13,489 admissions with NSTEMI; July 2005 to December 2006. MAIN OUTCOME MEASURES: Rate of angiography during index admission; death and readmission to hospital within 180 days. RESULTS: Significantly lower rates of angiography were seen for women, the elderly, the most deprived and those having cardiac, and most non-cardiac, comorbidities. Performance of angiography, compared with no angiography, was not associated with lower rate of readmission (multiple adjusted hazard ratio (HR) = 0.96, 95% CI 0.74 to 1.24) unless accompanied by coronary intervention (HR = 0.73, 95% CI 0.56 to 0.95). Angiography was associated with reduction in 180-day mortality for survivors of hospitalisation (HR = 0.59, 95% CI 0.49 to 0.72); with greater reduction when followed by an intervention (HR = 0.34, 95% CI 0.28 to 0.42). This mortality benefit after intervention was seen both in women (HR = 0.42, 95% CI 0.29 to 0.60) and men (HR = 0.31, 95% CI 0.24 to 0.41), and across age groups: <65 years (HR = 0.25, 95% CI 0.14 to 0.44), 65-79 years (HR = 0.29, 95% CI 0.22 to 0.39) and > or =80 years (HR = 0.52, 95% CI 0.37 to 0.74). Mortality benefit was not significantly attenuated by the presence of comorbidities. CONCLUSION: Performance of angiography and coronary intervention after NSTEMI was associated with mortality benefit that persisted in the presence of both cardiac and non-cardiac comorbidities. Mortality benefit was seen across age groups and was similar for both sexes. |
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Authors:
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J S Birkhead; C F M Weston; R Chen |
Publication Detail:
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Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't Date: 2009-06-08 |
Journal Detail:
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Title: Heart (British Cardiac Society) Volume: 95 ISSN: 1468-201X ISO Abbreviation: Heart Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-09-15 Completed Date: 2009-10-26 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9602087 Medline TA: Heart Country: England |
Other Details:
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Languages: eng Pagination: 1593-9 Citation Subset: AIM; IM |
Affiliation:
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National Institute for Clinical Outcomes Research, The Heart Hospital, London, UK. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Age Factors Aged Aged, 80 and over Coronary Angiography / mortality, statistics & numerical data* Female Hospitalization / statistics & numerical data Humans Male Medical Audit Myocardial Infarction / mortality, radiography* Patient Readmission / statistics & numerical data Patient Selection Recurrence Risk Assessment |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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