Early clinical outcomes and routine management of patients with non-ST-segment elevation myocardial infarction: a nationwide perspective
Authors
Becker, Richard C.Burns, Maureen
Every, Nathan
Maynard, Charles
Frederick, Paul D. F.
Spencer, Frederick A.
Gore, Joel M.
Lambrew, Costas
UMass Chan Affiliations
Department of Medicine, Division of Cardiovascular MedicineDocument Type
Journal ArticlePublication Date
2001-03-17Keywords
AgedCoronary Angiography
Electrocardiography
Female
Humans
Male
Myocardial Infarction
Myocardial Revascularization
Outcome Assessment (Health Care)
Prevalence
Recurrence
Registries
Retrospective Studies
Severity of Illness Index
United States
Life Sciences
Medicine and Health Sciences
Metadata
Show full item recordAbstract
BACKGROUND: Myocardial infarction (MI) in the absence of electrocardiographic ST-segment elevation or new bundle branch block is the cause of hospitalization for a large and steadily increasing proportion of patients with acute ischemic chest pain. Despite its prevalence, the common demographic features, current hospital-based management, and short-term clinical outcome among patients with non-ST-segment elevation MI remain poorly defined. METHODS: A total of 183 113 patients with non-ST-segment elevation MI were identified in the National Registry of Myocardial Infarction database. Using a validated model, 43 928 patients (24.0%) were retrospectively placed in major, 34 917 (19.1%) in intermediate, and 104 268 (56.9%) in minor severity clinical event categories that included hospital death, recurrent myocardial ischemia, and nonfatal recurrent MI. RESULTS: The administration of widely available and universally recommended pharmacologic therapies, including aspirin and beta-adrenergic blocking agents, was suboptimal, particularly among patients with major severity clinical events. In contrast, coronary angiography and mechanical revascularization procedures were commonplace (>60% of all patients) and most frequently performed in patients within the minor (compared with the major) severity clinical event category (58.2% and 42.7%, respectively). CONCLUSIONS: Patients with non-ST-segment elevation MI are a heterogeneous population, with readily identifiable demographic characteristics and clinical features associated with important early outcomes, including death. Nationwide efforts directed toward maximizing pharmacologic therapy utilization and the performance of invasive procedures according to established guidelines must continue.Source
Arch Intern Med. 2001 Feb 26;161(4):601-7.
DOI
10.1001/archinte.161.4.601Permanent Link to this Item
http://hdl.handle.net/20.500.14038/39526PubMed ID
11252122Related Resources
ae974a485f413a2113503eed53cd6c53
10.1001/archinte.161.4.601