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Late Consequences of Acute Coronary Syndromes: Global Registry of Acute Coronary Events (GRACE) Follow-up.

Publication ,  Journal Article
Alnasser, SMA; Huang, W; Gore, JM; Steg, PG; Eagle, KA; Anderson, FA; Fox, KAA; Gurfinkel, E; Brieger, D; Klein, W; van de Werf, F; Avezum, Á ...
Published in: Am J Med
July 2015

PURPOSE: Short-term outcomes have been well characterized in acute coronary syndromes; however, longer-term follow-up for the entire spectrum of these patients, including ST-segment-elevation myocardial infarction, non-ST-segment-elevation myocardial infarction, and unstable angina, is more limited. Therefore, we describe the longer-term outcomes, procedures, and medication use in Global Registry of Acute Coronary Events (GRACE) hospital survivors undergoing 6-month and 2-year follow-up, and the performance of the discharge GRACE risk score in predicting 2-year mortality. METHODS: Between 1999 and 2007, 70,395 patients with a suspected acute coronary syndrome were enrolled. In 2004, 2-year prospective follow-up was undertaken in those with a discharge acute coronary syndrome diagnosis in 57 sites. RESULTS: From 2004 to 2007, 19,122 (87.2%) patients underwent follow-up; by 2 years postdischarge, 14.3% underwent angiography, 8.7% percutaneous coronary intervention, 2.0% coronary bypass surgery, and 24.2% were re-hospitalized. In patients with 2-year follow-up, acetylsalicylic acid (88.7%), beta-blocker (80.4%), renin-angiotensin system inhibitor (69.8%), and statin (80.2%) therapy was used. Heart failure occurred in 6.3%, (re)infarction in 4.4%, and death in 7.1%. Discharge-to-6-month GRACE risk score was highly predictive of all-cause mortality at 2 years (c-statistic 0.80). CONCLUSION: In this large multinational cohort of acute coronary syndrome patients, there were important later adverse consequences, including frequent morbidity and mortality. These findings were seen in the context of additional coronary procedures and despite continued use of evidence-based therapies in a high proportion of patients. The discriminative accuracy of the GRACE risk score in hospital survivors for predicting longer-term mortality was maintained.

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Published In

Am J Med

DOI

EISSN

1555-7162

Publication Date

July 2015

Volume

128

Issue

7

Start / End Page

766 / 775

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Survival Analysis
  • Sex Distribution
  • Severity of Illness Index
  • Risk Assessment
  • Retrospective Studies
  • Registries
  • Patient Discharge
  • Middle Aged
 

Citation

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ICMJE
MLA
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Alnasser, S. M. A., Huang, W., Gore, J. M., Steg, P. G., Eagle, K. A., Anderson, F. A., … GRACE Investigators, . (2015). Late Consequences of Acute Coronary Syndromes: Global Registry of Acute Coronary Events (GRACE) Follow-up. Am J Med, 128(7), 766–775. https://doi.org/10.1016/j.amjmed.2014.12.007
Alnasser, Sami M. A., Wei Huang, Joel M. Gore, Ph Gabriel Steg, Kim A. Eagle, Frederick A. Anderson, Keith A. A. Fox, et al. “Late Consequences of Acute Coronary Syndromes: Global Registry of Acute Coronary Events (GRACE) Follow-up.Am J Med 128, no. 7 (July 2015): 766–75. https://doi.org/10.1016/j.amjmed.2014.12.007.
Alnasser SMA, Huang W, Gore JM, Steg PG, Eagle KA, Anderson FA, et al. Late Consequences of Acute Coronary Syndromes: Global Registry of Acute Coronary Events (GRACE) Follow-up. Am J Med. 2015 Jul;128(7):766–75.
Alnasser, Sami M. A., et al. “Late Consequences of Acute Coronary Syndromes: Global Registry of Acute Coronary Events (GRACE) Follow-up.Am J Med, vol. 128, no. 7, July 2015, pp. 766–75. Pubmed, doi:10.1016/j.amjmed.2014.12.007.
Alnasser SMA, Huang W, Gore JM, Steg PG, Eagle KA, Anderson FA, Fox KAA, Gurfinkel E, Brieger D, Klein W, van de Werf F, Avezum Á, Montalescot G, Gulba DC, Budaj A, Lopez-Sendon J, Granger CB, Kennelly BM, Goldberg RJ, Fleming E, Goodman SG, GRACE Investigators. Late Consequences of Acute Coronary Syndromes: Global Registry of Acute Coronary Events (GRACE) Follow-up. Am J Med. 2015 Jul;128(7):766–775.
Journal cover image

Published In

Am J Med

DOI

EISSN

1555-7162

Publication Date

July 2015

Volume

128

Issue

7

Start / End Page

766 / 775

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Survival Analysis
  • Sex Distribution
  • Severity of Illness Index
  • Risk Assessment
  • Retrospective Studies
  • Registries
  • Patient Discharge
  • Middle Aged