Poor long-term outcome in acute coronary syndrome in a real-life setting: Ten-year outcome of the TACOS study

Abstract

Background: Long-term outcome of the three categories of acute coronary syndrome (ACS) in real-life patient cohorts is not well known. The objective of this study was to survey the 10-year outcome of an ACS patient cohort admitted to a university hospital and to explore factors affecting the outcome. Methods: A total of 1188 consecutive patients (median age 73 years) with ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI) or unstable angina pectoris (UA) in 2002-2003 were included and followed up for ≥ 10 years. Results: Mortality for STEMI, NSTEMI and UA patients during the follow-up period was 52.5%, 69.9% and 41.0% (p < 0.001), respectively. In multivariable Cox regression analysis, only age and creatinine level at admission were independently associated with patient outcome in all the three ACS categories when analyzed separately. Conclusions: All the three ACS categories proved to have high mortality rates during long-term followup in a real-life patient cohort. NSTEMI patients had worse outcome than STEMI and UA patients during the whole follow-up period. Our study results indicate clear differences in the prognostic significance of various demographic and therapeutic parameters within the three ACS categories.

Long-term Survival After Out-of-Hospital Cardiac Arrest

“…74 Nevertheless, arguably the most suitable comparators are patients with acute myocardial infarction due to similar comorbidities and overlapping origins. 75,76 Studies 75,77,78 based on older data sets reported 10-year survival rates of discharged patients with ST-elevation myocardial infarction (STEMI) of approximately 50%. A newer study 79 reports a 10-year survival of 76.2%.…”

Elevated serum transaminases in patients with acute coronary syndromes: Do we need a revision of exclusion criteria for clinical trials?

“…As far as the accepted liver-based screening criteria for CCT are concerned, it appears that a significant group of patients may be excluded from dedicated clinical trials. Moreover, the rest of participants may not be representative of the real-world population with the disease [12][13][14]. On the other hand, recent evidence suggests that elevated serum transaminases are associated with more severe myocardial damage along with worse short-and long-term clinical outcomes [6,15,16].…”

Coronary Angioplasty and Stenting in Acute Coronary Syndromes Using Very Low Contrast Volume and Radiation Dosage Improves Renal and Cardiovascular Outcomes

“…Hence, preserving renal function in coronary artery disease patients should be considered a priority. 37 The intracranial bleeding rate was low, being seen in 1 patient. This patient improved after the evacuation of the clot by a neurosurgeon and subsequently came for follow-up.…”