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Long-Term clinical outcomes according to initial management and thrombolysis in myocardial infarction risk score in patients with acute non-ST-segment elevation myocardial infarction.

Authors
 Hae Chang Jeong  ;  Youngkeun Ahn  ;  Myung Ho Jeong  ;  Shung Chull Chae  ;  Seung Ho Hur  ;  Taek Jong Hong  ;  Young Jo Kim  ;  In Whan Seong  ;  Jei Keon Chae  ;  Jay Young Rhew  ;  In Ho Chae  ;  Myeong Chan Cho  ;  Jang Ho Bae  ;  Seung Woon Rha  ;  Chong Jin Kim  ;  Donghoon Choi  ;  Yang Soo Jang  ;  Junghan Yoon  ;  Wook Sung Chung  ;  Jeong Gwan Cho  ;  Ki Bae Seung  ;  Seung Jung Park 
Citation
 YONSEI MEDICAL JOURNAL, Vol.51(1) : 58-68, 2010 
Journal Title
 YONSEI MEDICAL JOURNAL 
ISSN
 0513-5796 
Issue Date
2010
MeSH
Age Factors ; Aged ; Angioplasty, Balloon, Coronary ; Female ; Fibrinolytic Agents/therapeutic use* ; Hemodynamics/drug effects ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Myocardial Infarction/drug therapy* ; Myocardial Infarction/pathology ; Myocardial Infarction/therapy ; Prospective Studies ; Thrombolytic Therapy/methods*
Keywords
Myocardial infarction ; TIMI risk score ; invasive treatment ; non-ST-segment elevation ; prognosis
Abstract
PURPOSE: There is still debate about the timing of revascularization in patients with acute non-ST-segment elevation myocardial infarction (NSTEMI). We analyzed the long-term clinical outcomes of the timing of revascularization in patients with acute NSTEMI obtained from the Korea Acute Myocardial Infarction Registry (KAMIR). MATERIALS AND METHODS: 2,845 patients with acute NSTEMI (65.6 +/- 12.5 years, 1,836 males) who were enrolled in KAMIR were included in the present study. The therapeutic strategy of NSTEMI was categorized into early invasive (within 48 hours, 65.8 +/- 12.6 years, 856 males) and late invasive treatment (65.3 +/- 12.1 years, 979 males). The initial- and long-term clinical outcomes were compared between two groups according to the level of Thrombolysis In Myocardial Infarction (TIMI) risk score. RESULTS: There were significant differences in-hospital mortality and the incidence of major adverse cardiac events during one-year clinical follow-up between two groups (2.1% vs. 4.8%, p < 0.001, 10.0% vs. 13.5%, p = 0.004, respectively). According to the TIMI risk score, there was no significant difference of long-term clinical outcomes in patients with low to moderate TIMI risk score, but significant difference in patients with high TIMI risk score (>or= 5 points). CONCLUSIONS: The old age, high Killip class, low ejection fraction, high TIMI risk score, and late invasive treatment strategy are the independent predictors for the long-term clinical outcomes in patients with NSTEMI.
Files in This Item:
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DOI
10.3349/ymj.2010.51.1.58
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/100627
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