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- Title
Are patients with non-ST elevation myocardial infarction undertreated?
- Authors
Saman Rasoul; Jan Paul Ottervanger; Dambrink, Jan-Henk E.; de Boer, Menko-Jan; Hoorntje, Jan CA; Gosselink, AT Marcel; Zijlstra, Felix; Suryapranata, Harry; van't Hof, Arnoud WJ
- Abstract
Background: The worse prognosis in patients without ST-elevation (non-STEMI) as compared to ST-elevation myocardial infarction (STEMI), may be due to treatment differences. We aimed to evaluate the differences in characteristics, treatment and outcome in patients with non-STEMI versus STEMI in an unselected patient population. Methods: Individual patient data from all patients in our hospital with a discharge diagnosis of MI between Jan 2001 and Jan 2002 were evaluated. Follow-up data were obtained until December 2004. Patients were categorized according to the presenting electrocardiogram into non-STEMI or STEMI. Results: A total of 824 patients were discharged with a diagnosis of MI, 29% with non-STEMI and 71% with STEMI. Patients with non-STEMI were significantly older and had a higher cardiovascular risk profile. They underwent less frequently coronary angiography and revascularization and received less often clopidogrel and ACE-inhibitor on discharge. Long-term mortality was significantly higher in the non-STEMI patients as compared to STEMI patients, 20% as. 12%, p =0.006, respectively. However, multivariate analysis showed that age, diabetes, hypertension and no reperfusion therapy (but not non-STEMI presentation) were independent and significant predictors of long-term mortality. Conclusion: In an unselected cohort of patients discharged with MI, there were significant differences in baseline characteristics, and (invasive) treatment between STEMI and non-STEMI. Long-term mortality was also different, but this was due to differences in baseline characteristics and treatment. More aggressive treatment may improve outcome in non-STEMI patients.
- Subjects
MYOCARDIAL infarction; CORONARY disease; DIAGNOSIS; ELECTROCARDIOGRAPHY; CARDIOVASCULAR diseases; CARDIOLOGY
- Publication
BMC Cardiovascular Disorders, 2007, Vol 7, p1
- ISSN
1471-2261
- Publication type
Article
- DOI
10.1186/1471-2261-7-8