Key result
Unstable angina is linked to ~86% lower 30-day mortality versus NSTEMI, with similar recurrent MI rates.
Why the study?
The relative incidence, characteristics, and outcomes of unstable angina compared with non-ST-elevation myocardial infarction were not well defined.
Do patients with unstable angina have different mortality and future MI outcomes compared to those with NSTEMI?
Population
8992 patients with acute chest discomfort presenting to emergency departments at 11 centres
Comparison
Unstable angina vs non-ST-elevation myocardial infarction
Design
Two independent prospective multicentre diagnostic cohort studies
Follow-up
30 days and 1 year
Authors
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May refine short-term ACS prognostication; leaves open whether unstable angina warrants distinct management from NSTEMI.
Observational (n=8,992)
Yes
Do patients with unstable angina have different mortality and future MI outcomes compared to those with NSTEMI?
Absolute Event Rate: 0.5% vs 3.7%
p-value: p=0.002
While unstable angina has lower short- and long-term mortality compared to NSTEMI, it carries a similar risk for future non-fatal myocardial infarction.
Puelacher et al. (2019) conducted an observational in Acute chest discomfort / suspected acute coronary syndrome (n=8,992). Unstable angina (UA) vs. Non-ST-elevation myocardial infarction (NSTEMI) was evaluated on All-cause mortality at 30 days (APACE cohort) (p=0.002). Unstable angina was associated with substantially lower 30-day all-cause mortality compared to NSTEMI (0.5% vs 3.7% in APACE; 0.7% vs 7.4% in High-STEACS), but future non-fatal MI rates were similar.
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