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Long-term mortality of patients undergoing cardiac catheterization for ST-elevation and non-ST-elevation myocardial infarction.

Publication ,  Journal Article
Chan, MY; Sun, JL; Newby, LK; Shaw, LK; Lin, M; Peterson, ED; Califf, RM; Kong, DF; Roe, MT
Published in: Circulation
June 23, 2009

BACKGROUND: There are limited contemporary data comparing long-term outcomes after cardiac catheterization for ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI). METHODS AND RESULTS: We studied patients undergoing cardiac catheterization for STEMI (n=2413) and NSTEMI (n=1974) between 1999 and 2005 with at least 1 significant coronary lesion > or =75%. We compared adjusted mortality rates over restricted time intervals and the differential impact of early revascularization on mortality stratified by ST-elevation status. Between 1999 and 2007, 1274 patients died, with a median follow-up of 4 years. A piece-wise analysis showed a higher adjusted mortality risk for STEMI during the first 2 months (adjusted hazard ratio, 1.85; 95% confidence interval, 1.45 to 2.38) and a lower adjusted mortality risk for STEMI after 2 months (adjusted hazard ratio, 0.68; 95% confidence interval, 0.59 to 0.83). Compared with late or no revascularization, early revascularization was associated with a lower adjusted risk of mortality for both STEMI (adjusted hazard ratio, 0.73; 95% confidence interval, 0.58 to 0.90) and NSTEMI (adjusted hazard ratio, 0.76; 95% confidence interval, 0.65 to 0.89) (P for interaction=0.22). CONCLUSIONS: Among a contemporary cohort of acute MI patients with significant coronary disease during cardiac catheterization, STEMI was associated with a higher risk of short-term mortality, but NSTEMI was associated with a higher risk of long-term mortality. Early revascularization was associated with a similar improvement in long-term outcomes for both STEMI and NSTEMI. These data suggest that in clinical investigations of early revascularization among patients with NSTEMI, extended follow-up may be necessary to demonstrate treatment benefit.

Duke Scholars

Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

June 23, 2009

Volume

119

Issue

24

Start / End Page

3110 / 3117

Location

United States

Related Subject Headings

  • Time Factors
  • Survival Rate
  • Risk Factors
  • Retrospective Studies
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • Follow-Up Studies
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Chan, M. Y., Sun, J. L., Newby, L. K., Shaw, L. K., Lin, M., Peterson, E. D., … Roe, M. T. (2009). Long-term mortality of patients undergoing cardiac catheterization for ST-elevation and non-ST-elevation myocardial infarction. Circulation, 119(24), 3110–3117. https://doi.org/10.1161/CIRCULATIONAHA.108.799981
Chan, Mark Y., Jie L. Sun, L Kristin Newby, Linda K. Shaw, Min Lin, Eric D. Peterson, Robert M. Califf, David F. Kong, and Matthew T. Roe. “Long-term mortality of patients undergoing cardiac catheterization for ST-elevation and non-ST-elevation myocardial infarction.Circulation 119, no. 24 (June 23, 2009): 3110–17. https://doi.org/10.1161/CIRCULATIONAHA.108.799981.
Chan MY, Sun JL, Newby LK, Shaw LK, Lin M, Peterson ED, et al. Long-term mortality of patients undergoing cardiac catheterization for ST-elevation and non-ST-elevation myocardial infarction. Circulation. 2009 Jun 23;119(24):3110–7.
Chan, Mark Y., et al. “Long-term mortality of patients undergoing cardiac catheterization for ST-elevation and non-ST-elevation myocardial infarction.Circulation, vol. 119, no. 24, June 2009, pp. 3110–17. Pubmed, doi:10.1161/CIRCULATIONAHA.108.799981.
Chan MY, Sun JL, Newby LK, Shaw LK, Lin M, Peterson ED, Califf RM, Kong DF, Roe MT. Long-term mortality of patients undergoing cardiac catheterization for ST-elevation and non-ST-elevation myocardial infarction. Circulation. 2009 Jun 23;119(24):3110–3117.

Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

June 23, 2009

Volume

119

Issue

24

Start / End Page

3110 / 3117

Location

United States

Related Subject Headings

  • Time Factors
  • Survival Rate
  • Risk Factors
  • Retrospective Studies
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • Follow-Up Studies
  • Female