Markers of Poor Prognosis in Non-ST Segment Elevation Acute Coronary Syndromes Without Revascularization: A 3-Year Survival Analysis
Journal Title: Journal of Medical Research and Innovation - Year 2018, Vol 2, Issue 2
Abstract
Introduction: The non-ST elevation acute coronary syndrome (NSTE-ACS) account for more than 50% of the total number of patients with ACS. The mortality rates after NSTEMI are not significantly different when compared with patients with ST-segment elevation myocardial infarction. Aim: The aim of the present study was to investigate whether the assessment of clinical, laboratory and instrumental data during hospital stay provide any additional independent information in predicting the 3-year major cardiac events after NSTE-ACS. Methods: We observed 490 consecutive patients, who were admitted to the emergency cardiology department with NSTE-ACS. The patients' baseline characteristics, blood analysis, left ventricle (LV) and renal function data were assessed and analyzed. The median follow‑up time was 36 months. The endpoint was cardiovascular death. Results: The results of our study show that the risk of cardiovascular death during the three years follow-up after multivariate adjustment increases with older age (> 64 years), history of diabetes, prior myocardial infarction and history of angina pectoris, lower ejection fraction (<50%), degree of myocardial hypertrophy (the thickness of the interventricular septum >1.25 mm) of the LV and the degree of diastolic dysfunction (E-wave deceleration time (DT) < 150 ms), silent myocardial ischemia during first 24-hours, high pulse pressure on Day 1 (>49 mm Hg), glucose level > 7.5 mmol/l on admission and moderate kidney dysfunction (CrCl <60 ml/min). Conclusion: In patients with NSTE-ACS, we report the cardiovascular death risk factors within the 3-year follow-up period in the present study. We thus conclude that it is important to identify the patients with high risk of future cardiovascular complications.
Authors and Affiliations
Alexander Parkhomenko, Natalia Dovgan, Yaroslav Lutay, Sergey Kozhukhov
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