Does treatment impact health outcomes for patients after acute coronary syndrome?
Jelena Umbrasienė1, Giedrius Vanagas2, Jon Venclovienė3
1Department of Preventive Medicine, Lithuanian University of Health Sciences, 57-302 Šiaurės ave, Kaunas LT-49264, Lithuania. jelena0110@yahoo.com.
Insights
Evidence-based treatment (EBT) significantly reduced cardiovascular mortality in acute coronary syndrome (ACS) patients. Adhering to EBT guidelines improved long-term survival rates for ACS survivors.
Area of Science:
- Cardiology
- Clinical Research
- Public Health
Background:
- Acute coronary syndrome (ACS) is associated with high global mortality rates.
- Investigating long-term treatment impacts on cardiovascular (CV) mortality post-ACS is crucial.
Purpose of the Study:
- To evaluate the effect of evidence-based treatment (EBT) on cardiovascular mortality eight years after ACS.
- To assess the impact of adherence to treatment guidelines on patient outcomes.
Main Methods:
- Retrospective cohort study of 613 ACS patients.
- Utilized logistic regression and standardized odds ratios for risk assessment.
- EBT algorithm based on ESC guidelines applied.
Main Results:
- Median follow-up was 7.6 years; 48.9% of patients died from CV causes.
- Evidence-based treatment (EBT) was administered to 37.8% of patients.
- EBT use significantly reduced CV mortality (HR 0.541, p<0.001).
Conclusions:
- Combined EBT significantly improved patient outcomes and reduced CV mortality.
- EBT was associated with higher rates of recurrent myocardial infarction and percutaneous coronary intervention, yet remained beneficial.
Background:
Mortality rates for acute coronary syndrome (ACS) patients are still very high all over the world. Our study aimed to investigate the impact of ACS treatment on cardiovascular (CV) mortality eight years following ACS.
Methods:
A retrospective cohort study with a total of 613 patients was used. The data was collected from databases and medical records. An evidence-based treatment (EBT) algorithm was used based on the ESC guidelines. Logistic regression analysis and standardized odds ratios with 95% confidence interval (CI) were used for the risk assessment, with a p level<0.05 considered as significant.
Results:
The median follow-up time in this study was 7.6 years. During follow-up 48.9% of the patients (n=300) died from CV and 207 (69%) for a relevant reason. For monotherapy ACE inhibitors and β-blockers, and for fixed dose combined drugs ACE inhibitors and diuretics, were most frequently used. EBT was provided to 37.8% of patients. The EBT use (HR 0.541, CI 0.394-0.742, p<0.001) during follow-up period was important for reducing CV mortality in ACS patients.
Conclusions:
The combined use of EBT significantly improved outcomes. The recurrent myocardial infarction and percutaneous coronary intervention patients were more frequent in EBT and it was beneficial for reducing CV mortality.
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