| Management and outcomes of acute coronary syndrome with minimal myocardial necrosis: analysis of a large prospective registry from a non-interventional centre. | |
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MedLine Citation:
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PMID: 16620349 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The aim of this study was to assess the clinical risk of minimal myonecrosis below the cut-off for acute myocardial infarction (MI) in comparison with other grades of acute coronary syndrome (ACS). One-thousand four hundred and sixty seven consecutive patients with ACS admitted between May 2001 and April 2002 were studied in a non-interventional centre. Patients were divided into unstable angina (UA) (cTnT < 0.01 microg/l), non-ST elevation ACS with minimal myonecrosis (0.01 <or= cTnT < 0.1 microg/l), non-ST elevation MI (NSTEMI) (cTnT >or= 0.1 microg/L) and ST elevation myocardial infarction (STEMI). UA (n = 638) was associated with the fewest events at 6 months (2% cardiac death or MI). Patients with any myonecrosis (n = 829) had worse outcomes (6-month cardiac death or MI 18.3-23.3%). Compared with ACS patients with minimal myonecrosis, UA patients were at significantly lower risk (OR 0.21, 95% CI 0.12-0.45, p < 0.001), NSTEMI patients were at similar risk (OR 1.45, 95% CI 0.89-2.35, p = 0.13), and STEMI patients were at higher risk (OR 2.12 95% CI 1.26-3.85, p = 0.008) in adjusted analyses. Nearly 85% of cardiac deaths occurred within 6 months. The risk of adverse events was higher among patients managed by non-cardiologists (OR 1.66, 95% CI 1-2.75, p = 0.049). Patients with non-ST elevation ACS and minimal myonecrosis are a high-risk group more comparable with NSTEMI and clearly distinguishable from patients with UA. |
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Authors:
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K K Ray; P J Sheridan; J Bolton; T C Clayton; A Veitch; R Manivarmane; A Al Rifai; G Payne; W Baig |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: International journal of clinical practice Volume: 60 ISSN: 1368-5031 ISO Abbreviation: Int. J. Clin. Pract. Publication Date: 2006 Apr |
Date Detail:
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Created Date: 2006-04-19 Completed Date: 2006-12-04 Revised Date: 2007-02-14 |
Medline Journal Info:
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Nlm Unique ID: 9712381 Medline TA: Int J Clin Pract Country: England |
Other Details:
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Languages: eng Pagination: 383-90 Citation Subset: IM |
Affiliation:
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Cardiology Department, Doncaster Royal Infirmary, Doncaster, UK. kkray@partners.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angina, Unstable / drug therapy*, pathology Coronary Angiography Female Humans Male Middle Aged Myocardial Infarction / drug therapy*, pathology Myocardium / pathology* Necrosis Prognosis Prospective Studies Risk Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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