Long term clinical outcome and bleeding complications among hospital survivors with acute coronary syndromes

Postgraduate Medical Journal
P WongE Rodrigues

Abstract

To examine the 21 month clinical outcome and bleeding complications in hospital survivors with non-ST segment elevation acute coronary syndromes (NSTEACS) who were discharged with combined clopidogrel and aspirin anti-thrombotic therapy, and compare with those having ST segment elevation myocardial infarction (STEMI) who were discharged with aspirin alone. Observational study. A large university hospital. 224 patients were admitted to hospital with either NSTEACS or STEMI, and survived to discharge between 1 October 2001 and 31 December 2002. Cardiovascular death, total death, new myocardial infarction, unstable angina requiring hospitalisation, stroke or transient ischaemic attack, coronary revascularisation; and fatal, life threatening, major and minor bleeding over 21 months after discharge. Despite having no or small infarct (median maximum creatine kinase 155 v 1295 u/l; p<0.001) and taking more antianginal drugs, patients with NSTEACS had similar rates of cardiovascular death (9.5% v 8.3%; p = NS), new myocardial infarction (9.5% v 6.5%; p = NS) or unstable angina requiring hospitalisation (15.5% v 10.2%; p = NS) when compared with STEMI. Fatal, life threatening or major bleeding were <1% in both groups (p = NS); and mino...Continue Reading

References

Aug 25, 2001·The New England Journal of Medicine·S YusufUNKNOWN Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial Investigators
Sep 25, 2002·Circulation·Andrzej BudajUNKNOWN Clopidogrel in Unstable angina to prevent Recurrent Events (CURE) Trial Investigators
Dec 31, 2002·European Heart Journal·Michel E BertrandUNKNOWN Task Force on the Management of Acute Coronary Syndromes of the European Society of Cardiology
Feb 1, 2003·European Heart Journal·Frans Van de WerfUNKNOWN Task Force on the Management of Acute Myocardial Infarction of the European Society of Cardiology
Aug 18, 2004·Heart·J S BirkheadUNKNOWN National Audit of Myocardial Infarction Project Steering Group
Mar 11, 2005·The New England Journal of Medicine·Marc S SabatineUNKNOWN CLARITY-TIMI 28 Investigators

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