Journal article
Characteristics and in-hospital outcomes of patients presenting with non-ST-segment elevation myocardial infarction found to have significant coronary artery disease on coronary angiography and managed medically: Stratification according to renal function
The American heart journal, Vol.164(1), pp.52-57.e1
07/01/2012
DOI: 10.1016/j.ahj.2012.04.009
PMID: 22795282
Abstract
Background The characteristics, therapies, and outcomes of patients presenting with non-ST-segment elevation myocardial infarction, found to have significant coronary artery disease on coronary angiography, and managed without revascularization ("nonrevascularized patients") have not been evaluated previously in a large-scale registry.
Methods We examined data on 13,872 non-ST-segment elevation myocardial infarction nonrevascularized patients who were captured by the Acute Coronary Treatment and Intervention Outcomes Network registry. Patients were divided according to baseline renal function in 4 groups: no chronic kidney disease (CKD) and CKD stages 3, 4, and 5.
Results The in-hospital mortality of nonrevascularized patients was 3.7%, whereas their in-hospital major bleeding rate was 10.8%. Overall, 44.2% (n = 6,132) of nonrevascularized patients had CKD. Compared with patients with normal renal function, nonrevascularized patients with CKD had significantly more history of myocardial infarction, heart failure, more 3-vessel coronary artery disease, and received fewer antithrombotic therapies. In addition, they had significantly higher rates of in-hospital mortality and major bleeding; CKD stage 4 was associated with the highest risk of adverse events. The multivariable-adjusted odds ratios of in-hospital mortality for CKD stages 3, 4, and 5 relative to no CKD were 1.5, 2.5, and 2.2, respectively (global P < .0001), and the analogous adjusted odds ratios of major bleeding were 1.5, 2.5, and 1.8 (global P < .0001).
Conclusion Nonrevascularized patients have a high in-hospital mortality. Nonrevascularized patients with CKD have more comorbidities than patients without CKD and less frequently receive guideline-recommended therapies. Chronic kidney disease is strongly associated with in-hospital mortality and bleeding. (Am Heart J 2012;164:52-57.e1.)
Details
- Title: Subtitle
- Characteristics and in-hospital outcomes of patients presenting with non-ST-segment elevation myocardial infarction found to have significant coronary artery disease on coronary angiography and managed medically: Stratification according to renal function
- Creators
- Elias B. Hanna - Louisiana State UniversityAnita Y. Chen - Duke Medical CenterMatthew T. Roe - Duke Medical CenterJorge F. Saucedo - University of Oklahoma Health Sciences Center
- Resource Type
- Journal article
- Publication Details
- The American heart journal, Vol.164(1), pp.52-57.e1
- Publisher
- Elsevier
- DOI
- 10.1016/j.ahj.2012.04.009
- PMID
- 22795282
- ISSN
- 0002-8703
- eISSN
- 1097-6744
- Number of pages
- 7
- Grant note
- Schering-Plough; Merck & Company; Schering Plough Corporation American College of Cardiology: BMS/Sanofi-Aventis
- Language
- English
- Date published
- 07/01/2012
- Academic Unit
- Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984359593102771
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