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[Long-term outcome after coronary emergency intervention]
1Medizinische Klinik, Kardiologie, Universitätsklinikum Charité, Humboldt Universität zu Berlin. eckart.frantz@charite.de
Insights
Emergency coronary angioplasty (CAG) for acute coronary syndromes shows similar long-term outcomes to elective CAG. This study found no significant differences in mortality or morbidity between emergency and elective procedures, highlighting comparable prognostic significance.
Area of Science:
- Cardiology
- Interventional Cardiology
- Clinical Outcomes Research
Background:
- Coronary angioplasty (CAG) is a standard treatment for acute coronary syndromes, including myocardial infarction (MI) and unstable angina (UA).
- Existing data often compare emergency CAG with elective procedures, but outcomes require further investigation.
Purpose of the Study:
- To compare the long-term results of emergency CAG in patients with acute coronary syndromes against those undergoing elective CAG.
- To determine if emergency treatment for acute coronary syndromes impacts prognosis compared to planned procedures.
Main Methods:
- A retrospective study comparing 581 patients undergoing emergency CAG with 2,460 patients undergoing elective CAG between July 1994 and December 1996.
- Follow-up data, including survival, repeat cardiac catheterizations, interventions, and myocardial infarction occurrence, were collected for approximately 22 months in 93.2% of patients.
Main Results:
- No significant differences in mortality rates were observed between the emergency (4.4%) and elective (3.7%) CAG groups.
- Repeat cardiac catheterization, interventions, coronary bypass surgery, and re-admission rates were also comparable between the two groups.
- The rate of subsequent emergency CAG was significantly higher in the emergency cohort (16.8%) compared to the elective cohort (8.8%; p < 0.001).
Conclusions:
- Coronary angiography performed during an acute coronary syndrome does not appear to have prognostic significance for long-term mortality and morbidity.
- Emergency and elective CAG demonstrate similar clinical outcomes after the acute phase of the disease.
- The findings support the use of CAG in acute settings without compromising long-term patient prognosis.
Background And Objective:
Coronary angioplasty (CAG) has become an acceptable method of treating an acute coronary syndrome (myocardial infarction [MI] or unstable angina [UA]). It was the aim of this study to determine whether the results of such emergency treatment differed from those after elective CAG.
Patients And Methods:
Results of emergency CAG in 581 patients (aged 60 +/- 11 years; 77% males) admitted to the authors' hospital between July 1994 and December 1996 were compared with those of elective CAG in 2,460 patients (aged 61 +/- 10, admitted during the same period. Follow-up information was obtained after 22.4 +/- 11 months in 93.2% of the patients by examination, written answers to annual questionnaires, data being collected on survival, repeat cardia catheterizations, other interventions, aorto-coronary bypass, occurrence of myocardial infarction, the patients' general state and drugs received.
Results:
19 of 517 patients (3.7%) of the group who had undergone elective CAG had died during the follow-up period, compared with 107 of 2436 of the emergency cohort (4.4%; not significant). There were also no significant differences regarding repeat cardiac catheterization, interventions, coronary bypass or re-admission. The proportion of subsequent emergency CAG among all CAGs was 16.8% in the emergency cohort, 8.8% after elective angiography (p < 0.001).
Conclusion:
Coronary angiography performed in patients with an acute coronary syndrome has no prognostic significance regarding mortality and morbidity after the acute phase of the disease.