Reference : Outcomes in patients with acute and stable coronary syndromes; insights from the pros...
Scientific journals : Article
Human health sciences : Cardiovascular & respiratory systems
Outcomes in patients with acute and stable coronary syndromes; insights from the prospective NOBORI-2 study
Fath-Ordoubadi, F. A [Manchester Heart Centre, Manchester Royal Infirmary, Manchester, United Kingdom]
Spaepen, E. B [SBD Analytics, Hertstraat, Bekkevoort, Belgium]
El-Omar, M. A [Division of Cardiology, Fondazione IRCCS Ca Granda, Ospedale Maggiore Policlinico, Milan, Italy]
Fraser, D. G. A [Department of Cardiology, Rambam Medical Center, Haifa, Israel]
Khan, M. A. A [European Medical and Clinical Division, Terumo Europe, Leuven, Belgium]
Neyses, Ludwig mailto [University of Luxembourg > Rectorate > Research Service]
Danzi, G. B. C [> >]
Roguin, A. D [> >]
Paunovic, D. E [> >]
Mamas, M. A. A F [> >]
Public Library of Science
Yes (verified by ORBilu)
[en] acute coronary syndrome; adult; article; cardiovascular mortality; Charlson Comorbidity Index; female; heart death; heart disease; heart muscle revascularization; human; major clinical study; male; middle aged; multicenter study; non ST segment elevation myocardial infarction; outcome assessment; percutaneous coronary intervention; prognosis; prospective study; ST segment elevation myocardial infarction; stable angina pectoris ; Acute Coronary Syndrome; Aged; Angina ; Stable; Death; Demography; Drug-Eluting Stents; Female; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Percutaneous Coronary Intervention; Proportional Hazards Models; Prospective Studies; Treatment Outcome
[en] Background: Contemporary data remains limited regarding mortality and major adverse cardiac events (MACE) outcomes in patients undergoing PCI for different manifestations of coronary artery disease. Objectives: We evaluated mortality and MACE outcomes in patients treated with PCI for STEMI (ST-elevation myocardial infarction), NSTEMI (non ST-elevation myocardial infarction) and stable angina through analysis of data derived from the Nobori-2 study. Methods: Clinical endpoints were cardiac mortality and MACE (a composite of cardiac death, myocardial infarction and target vessel revascularization). Results: 1909 patients who underwent PCI were studied; 1332 with stable angina, 248 with STEMI and 329 with NSTEMI. Age-adjusted Charlson co-morbidity index was greatest in the NSTEMI cohort (3.78±1.91) and lowest in the stable angina cohort (3.00±1.69); P<0.0001. Following Cox multivariate analysis cardiac mortality was independently worse in the NSTEMI vs the stable angina cohort (HR 2.31 (1.10-4.87), p = 0.028) but not significantly different for STEMI vs stable angina cohort (HR 0.72 (0.16-3.19), p = 0.67). Similar observations were recorded for MACE (<180 days) (NSTEMI vs stable angina: HR 2.34 (1.21-4.55), p = 0.012; STEMI vs stable angina: HR 2.19 (0.97-4.98), p = 0.061. Conclusions: The longer-term Cardiac mortality and MACE were significantly worse for patients following PCI for NSTEMI even after adjustment of clinical demographics and Charlson co-morbidity index whilst the longer-term prognosis of patients following PCI STEMI was favorable, with similar outcomes as those patients with stable angina following PCI. © 2014 Fath-Ordoubadi et al.
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