Why the study?
Dynamic changes in the clinical profile and treatment strategy of NSTEMI patients have been observed, but their exact impact on prognosis in a wide national population remains unclear.
Does a routine invasive strategy reduce mortality in patients with NSTEMI?
Does a routine invasive strategy reduce mortality in patients with NSTEMI?
A routine invasive strategy significantly improved in-hospital and 12-month mortality in NSTEMI patients in Poland over a decade.
Observed NSTEMI mortality declines may reflect advances; leaves open causal attribution pending prospective confirmation.
INTRODUCTION: Dynamic changes both in clinical profile and treatment strategy of non ST-segment elevation myocardial infarction (NSTEMI) patients have been observed recently. The exact impact of them on prognosis in a wide national population remains unclear. AIM: To evaluate the impact of treatment advances between 2005 and 2014 on the outcomes of NSTEMI cases. MATERIAL AND METHODS: NSTEMI patients from the Polish Registry of Acute Coronary Syndromes (PL-ACS) were included to the analysis. The mortality rate in a hospital observation as well as in 12-month follow-up was evaluated. RESULTS: < 0.001, respectively). Invasive strategy appeared to be the strongest factor decreasing mortality. Into in-hospital observation it reduces triple mortality risk whereas in 12-month follow up twice. Using propensity score matching analysis the impact of the treatment improvements on relative risk reduction was estimated on over 60%. CONCLUSIONS: In last decade the outcomes of NSTEMI in Poland improved substantially. The predominant impact on it had a routine invasive strategy.
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Piątek et al. (2020) studied this question.
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