Management and outcomes of acute coronary syndrome with minimal myocardial necrosis: analysis of a large prospective registry from a non-interventional centre

International Journal of Clinical Practice
K K RayW Baig

Abstract

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-cardiologist...Continue Reading

References

Dec 1, 1989·Journal of Molecular and Cellular Cardiology·H A KatusW Kübler
Oct 31, 1996·The New England Journal of Medicine·E M OhmanE J Topol
Jul 21, 1998·Journal of the American College of Cardiology·C A PolanczykP A Johnson
Jan 20, 2000·The New England Journal of Medicine·UNKNOWN Heart Outcomes Prevention Evaluation Study InvestigatorsG Dagenais
Jun 23, 2001·The New England Journal of Medicine·C P CannonUNKNOWN TACTICS (Treat Angina with Aggrastat and Determine Cost of Therapy with an Invasive or Conservative Strategy)--Thrombolysis
Aug 25, 2001·The New England Journal of Medicine·S YusufUNKNOWN Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial Investigators
Oct 6, 2001·Annals of Clinical Biochemistry·P O CollinsonD C Gaze
Sep 19, 2003·Lancet·K M Fox, UNKNOWN EURopean trial On reduction of cardiac events with Perindopril in stable coronary Artery disease Investigators
Mar 10, 2004·The New England Journal of Medicine·Christopher P CannonUNKNOWN Pravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysis in Myocardial Infarction 22 Investigators
Mar 19, 2004·Journal of the American College of Cardiology·Michael C KontosRobert L Jesse
May 18, 2004·Heart·K A A FoxUNKNOWN British Cardiac Society Working Group
Aug 13, 2004·The New England Journal of Medicine·Pim van der HarstDirk J van Veldhuisen
Aug 18, 2004·Heart·J S BirkheadUNKNOWN National Audit of Myocardial Infarction Project Steering Group
Sep 1, 2004·JAMA : the Journal of the American Medical Association·James A de LemosUNKNOWN Investigators
Mar 11, 2005·The New England Journal of Medicine·Marc S SabatineUNKNOWN CLARITY-TIMI 28 Investigators

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