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Long-Term Clinical Outcomes according to Initial Management and Thrombolysis In Myocardial Infarction Risk Score in Patients with Acute Non-ST-Segment Elevation Myocardial Infarction

Authors
Jeong, Hae ChangAhn, YoungkeunJeong, Myung HoChae, Shung ChullHur, Seung HoHong, Taek JongKim, Young JoSeong, In WhanChae, Jei KeonRhew, Jay YoungChae, In HoCho, Myeong ChanBae, Jang HoRha, Seung WoonKim, Chong JinChoi, DonghoonJang, Yang SooYoon, JunghanChung, Wook SungCho, Jeong GwanSeung, Ki BaePark, Seung Jung
Issue Date
1-Jan-2010
Publisher
YONSEI UNIV COLL MEDICINE
Keywords
Myocardial infarction; non-ST-segment elevation; invasive treatment; TIMI risk score; prognosis
Citation
YONSEI MEDICAL JOURNAL, v.51, no.1, pp.58 - 68
Indexed
SCIE
SCOPUS
KCI
Journal Title
YONSEI MEDICAL JOURNAL
Volume
51
Number
1
Start Page
58
End Page
68
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/117185
DOI
10.3349/ymj.2010.51.1.58
ISSN
0513-5796
Abstract
Purpose: There is still debate about the timing of revascularization in patients with acute non-ST-segment elevation myocardial infarction (NSTEMI). We analyzed the long-term clinical outcomes of the timing of revascularization in patients with acute NSTEMI obtained from the Korea Acute Myocardial Infarction Registry (KAMIR). Materials and Methods: 2,845 patients with acute NSTEMI (65.6 +/- 12.5 years, 1,836 males) who were enrolled in KAMIR were included in the present study. The therapeutic strategy of NSTEMI was categorized into early invasive (within 48 hours, 65.8 +/- 12.6 years, 856 males) and late invasive treatment (65.3 +/- 12.1 years, 979 males). The initial- and long-term clinical outcomes were compared between two groups according to the level of Thrombolysis In Myocardial Infarction (TIMI) risk score. Results: There were significant differences in-hospital mortality and the incidence of major adverse cardiac events during one-year clinical follow-up between two groups (2.1% vs. 4.8%, p < 0.001, 10.0% vs. 13.5%, p = 0.004, respectively). According to the TIMI risk score, there was no significant difference of long-term clinical outcomes in patients with low to moderate TIMI risk score, but significant difference in patients with high TIMI risk score (>= 5 points). Conclusion: The old age, high Killip class, low ejection fraction, high TIMI risk score, and late invasive treatment strategy are the independent predictors for the long-term clinical outcomes in patients with NSTEMI.
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