[Hospital and long-term prognosis of patients with non-ST-segment elevation myocardial infarction]
András Jánosi1, Dániel Várnai, Zsófia Adám
1Fovárosi Onkormányzat Szent János Kórháza és Eszak-budai Egyesített Kórházak III, Belgyógyászat-Kardiológia, Budapest. janosiandrasdr@gmail.com
Insights
This study on non-ST-segment elevation myocardial infarction found older age and specific echocardiographic factors predict mortality. Medication adherence remained high post-discharge.
Area of Science:
- Cardiology
- Clinical Medicine
- Public Health
Background:
- Non-ST-segment elevation myocardial infarction (NSTEMI) is a significant cause of cardiac mortality.
- Understanding long-term prognosis and predictors of mortality in NSTEMI patients is crucial for effective management.
- Comorbidities like diabetes, hypertension, and prior ischemic heart disease are common in NSTEMI populations.
Purpose of the Study:
- To analyze the clinical data, hospital, and long-term prognosis of patients with NSTEMI.
- To identify predictors of mortality, including demographic, clinical, and echocardiographic factors.
- To evaluate medication adherence to guideline recommendations at hospital discharge and during follow-up.
Main Methods:
- Retrospective analysis of clinical data from 139 consecutive NSTEMI patients.
- A three-quarter-year follow-up using postal questionnaires, achieving 98% completion.
- Assessment of echocardiographic parameters and hospital discharge medications.
Main Results:
- The mean age was 78.6 years for females and 71.4 years for males, with high comorbidity rates.
- Hospital mortality was 15%, and 17% died during the follow-up period. Older age was associated with higher mortality.
- Prognostically important echocardiographic parameters included ejection fraction, end-systolic diameter, wall motion abnormality, and mitral regurgitation severity.
Conclusions:
- Older age and specific echocardiographic findings are significant predictors of mortality in NSTEMI patients.
- Hospital discharge medication adherence in this cohort was notably high and sustained post-discharge.
- These findings highlight the importance of comprehensive assessment and guideline-based care in NSTEMI management.
Abstract:
The authors analyze some clinical data, hospital and long-term prognosis of 139 consecutive patients with non-ST-segment elevation myocardial infarction. A three-quarter-year long follow-up of patients was performed, and data were recorded by use of postal questionnaire. The follow-up was complete in 98% of the patients. The mean age was 78.6 and 71.4 years in the case of female and male patients, respectively. High percent of patients had comorbidity (diabetes mellitus, hypertension and previous ischemic heart disease). Coronary angiography was performed in 30 patients (22%) and revascularization in 29 of them. Hospital mortality was found in 15% and during follow-up 17% of the patients died. The patients who died during hospital stay and during the follow-up period were significantly older than patients who stayed alive. Some echocardiographic parameters were also found prognostically important: ejection fraction, end systolic diameter, segmental wall motion abnormality and severity of mitral regurgitation were found significantly different in patients alive and who died. The authors investigated the hospital discharge medications according to guideline recommendations. The authors emphasize that this quality indicator was much better in this patient population than the earlier published data. By the end of follow-up, similar percent of patients used these drugs as at the time of hospital discharge.
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