Prediction of one-year survival in high-risk patients with acute coronary syndromes: results from the SYNERGY trial

Journal of General Internal Medicine
Kenneth W MahaffeySYNERGY Trial Investigators

Abstract

Despite advances in pharmacologic therapy and invasive management strategies for patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS), these patients still suffer substantial morbidity and mortality. The objective of this study was to analyze independent predictors of 1-year mortality in patients with high-risk NSTE ACS. A total of 9,978 patients were assigned to receive enoxaparin or unfractionated heparin (UFH) in this prospective, randomized, open-label, international trial. Vital status at 1 year was collected. Univariable and multivariable predictors of 1-year mortality were identified. Three different multivariable regression models were constructed to identify: (1) predictors of 30-day mortality; (2) predictors of 1-year mortality; (3) predictors of 1-year mortality in 30-day survivors. The last model is the focus of this paper. Overall, 9,922 (99.4%) of patients had 1-year follow-up. Of the 56 patients (37 UFH-assigned and 19 enoxaparin-assigned) without 1-year data, 11 patients were excluded because of withdrawal of consent, and 45 could not be located. One-year mortality was 7.5% (7.7% enoxaparin-assigned patients; 7.3% UFH-assigned patients; P = 0.4). In patients surviving 30 days after enrollme...Continue Reading

References

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Citations

Aug 25, 2011·BMC Medicine·Erlend AuneJan Erik Otterstad
Jan 27, 2012·Circulation Journal : Official Journal of the Japanese Circulation Society·Yihua WuJun Yang
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