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Is having a moderate or low history, electrocardiogram, age, risk factors, troponin risk score a handicap for

Ertan Sonmez1, Bahadır Taslidere2, Mustafa Alper Deniz2

  • 1Malatya Education and Research Hospital, Department of Emergency Medicine - Malatya, Turkey.

Revista Da Associacao Medica Brasileira (1992)
|May 8, 2024
PubMed

Insights

High-risk patients with acute coronary syndrome have lower 6-month mortality when assessed using history, ECG, age, risk factors, and troponin scores. Further research is needed to reduce mortality in moderate and low-risk groups.

Area of Science:

  • Cardiology
  • Emergency Medicine

Background:

  • Acute coronary syndrome (ACS) risk stratification is crucial for emergency department (ED) patient management.
  • Traditional risk factors and troponin levels aid in assessing ACS prognosis.
  • Early discharge protocols aim to safely manage low-risk ACS patients.

Purpose of the Study:

  • To investigate the 6-month mortality in patients with suspected non-ST elevation acute coronary syndrome (NSTE-ACS).
  • To evaluate the association between a comprehensive risk score (history, electrocardiogram, age, risk factors, troponin) and long-term mortality.

Main Methods:

  • A retrospective study included 949 NSTE-ACS patients admitted to the ED.
  • Risk scores were calculated by clinicians based on history, ECG, age, risk factors, and troponin.
  • Six-month mortality was compared across different risk score groups.

Main Results:

  • The mean age of patients was 67.9 years, with 57.3% males.
  • Six-month mortality was significantly lower in the high-risk group (12.1%) compared to moderate (22%) and low-risk (25.3%) groups (p=0.019).

Conclusions:

  • A high composite risk score (history, ECG, age, risk factors, troponin) was associated with lower 6-month mortality in NSTE-ACS patients.
  • Prompt treatment, such as coronary angioplasty, is often indicated for high-risk patients.
  • Further studies are required to identify strategies for reducing mortality in moderate and low-risk NSTE-ACS patients.
Abstract

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