Comparative Ten-Year Outcomes in Chronic and Acute Coronary Syndrome Patients Undergoing Invasive Diagnostics—Insights from the KORONEF Registry

Background: This study aimed to characterize acute coronary syndrome (ACS) patients undergoing invasive diagnostics and to evaluate prognostic factors for all-cause mortality over a 10-year follow-up period. Methods: The KORONEF study was a prospective, observational, single-center study that enrolled 492 patients, of whom 467 had confirmed coronary artery disease (CAD). Baseline demographic, clinical, laboratory, and procedural data were analyzed, focusing on the differences between ACS and chronic coronary syndrome (CCS) patients. Results: Males made up the majority of both the CCS and ACS groups (62.2% vs. 63.6%, p = 0.773), with no statistically significant difference in patient age between the CCS and ACS subpopulations (64.9 ± 9.5 vs. 63.7 ± 10.3, p = 0.106). The 10-year all-cause mortality was 29.8%, with no statistically significant difference between ACS and CCS patients. However, statistically significantly more patients with CCS underwent CABG in the follow-up than ACS patients (9.9% vs. 4.6%, p = 0.042). In a multivariable analysis, in the ACS subgroup, statistically significant predictors of all-cause mortality at 10 years included being between 75 and 90 years old (HR 4.99), not having had a previous stroke (HR 0.27), the absence of cardiac arrest (HR 0.20), and a left ventricular ejection fraction > 60% (HR 0.23). Conclusions: The long-term outcomes of the ACS patients highlight age and left ventricular function as significant prognostic factors, underscoring the importance of these parameters in risk stratification.