Key result
ST-elevation acute coronary syndrome was associated with a significantly lower rate of fatal outcomes at 6 months post-discharge compared to non-ST-elevation acute coronary syndrome (2.8% vs 5.0%, RR 0.554).
Observational (n=2,370)
Yes
Relative Risk: 0.554 (95% CI 0.308–0.998)
Absolute Event Rate: 2.8% vs 5%
p-value: p=0.038
In a Russian registry of ACS patients, 6-month post-discharge mortality was 4.2%, and significant declines in adherence to guideline-directed medical therapy were observed.
Questions standard post-discharge ACS risk expectations; observational data leaves open need for prospective confirmation.
Erlikh A. D. on behalf of the RECORD-3* working team Aim . Evaluation of 6-month observation of acute coronary syndrome (ACS) patients included into the ACS registry RECORD-3. Material and methods . To the registry RECORD-3, all ACS patients were being included if hospitalized during 1 month in 2015 (march-april) in 47 centers among 37 Russia cities. Follow-up lasted for 6 months with telephone calls, in 35 centers. Results. Among all participants (n=2370), 6-month outcomes were collected in 1433 (64%). By most demographic, anamestic and clinical characteristics the group of those failed to collect data was comparable with the others. Frequency of fatal outcomes after discharge in 6 months post ACS was 4,2%, new myocardial infarction (MI) — 3,2%, stroke — 0,7%. Frequency of combination events (death+MI), death+ MI+stroke reached 5,7% and 8,5%, respectively. Coronary intervention in 6 months was done in 12,0% (2/3 underwent PCI, 1/3 — bypass surgery). In 19% cases the intervention was urgent. There were no statistically significant differences by the prevalence of adverse events and bypass surgery among those with diagnosed MI in-patient and non-MI, as between ACS with ST elevation (STEACS) or no (NSTEACS), excluding the prevalence of fatal outcomes: 2,8% in STEACS and 5,0% in NSTEACS (p=0,038). The grade of frequency decline of prescribed medication intake by 6 months reached 12% for aspirin, 29% for clopidogrel, 33% for ticagrelor, 29% for oral anticoagulants, 28 for ACEi/ARB, 19% for beta-blockers, 21% for statins. Conclusion. By multifactorial regression analysis, the independent predictors of fatal outcomes were found, that developed in 6 months post discharge.
No takes yet. Share an insight, caveat, or question.
А. Д. Эрлих (2017) conducted an observational in Acute Coronary Syndrome (ACS) (n=2,370). ST-elevation acute coronary syndrome (STE-ACS) vs. Non-ST-elevation acute coronary syndrome (NSTE-ACS) was evaluated on Fatal outcomes at 6 months post-discharge (RR 0.554, 95% CI 0.308-0.998, p=0.038). ST-elevation acute coronary syndrome was associated with a significantly lower rate of fatal outcomes at 6 months post-discharge compared to non-ST-elevation acute coronary syndrome (2.8% vs 5.0%, RR 0.554).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: