Abstract 14927: Long-term Prognosis Of First Myocardial Infarction According To The Electrocardiographic Pattern (st Elevation Myocardial Infarction, Non-st Elevation Myocardial Infarction And Non-classified Myocardial Infarction) And Revascularization Procedures
Aim: To describe the differences in the characteristics and short- and long-term prognosis of first acute myocardial infarction (MI) patients according to the presence of ST elevation (STEMI) or not (NSTEMI) or non-classified MI.
Methods: Between 2001-2003, 2048 first MI patients were consecutively admitted to 6 participating Spanish hospitals and categorized as STEMI, NSTEMI or non-classified MI (pacemaker or left bundle branch block) according to the electrocardiogram at admission.
Results: The proportion of women, hypercholesterolemia, hypertension, and diabetes was higher in NSTEMI patients than in the STEMI group. NSTEMI 28-day case-fatality was lower (2.99% vs 5.26%, p=0.02). In the multivariate analysis, the odds ratio of 28-day case-fatality was 2.23 for STEMI patients compared to NSTEMI patients (95% CI: 1.29-3.83; p-value=0.004). The multivariate adjusted 7-year mortality for 28-day survivors was higher in NSTEMI than STEMI (HR=1.31; 95% CI: 1.02-1.68; p-value=0.035). However, the patients with non-classified MI presented the highest short- and long-term mortality (11.8% and 35.4%, respectively). The excess of short-term mortality in non-classified and STEMI patients was mainly observed in those patients non treated with revascularization procedures.
Conclusions: patients with first NSTEMI are older and show a higher proportion of previous coronary risk factor than STEMI patients. NSTEMI patients have lower 28-day case-fatality but a worse 7-year mortality rate than STEMI patients. Non-classified MI presented the worst short- and long-term prognosis. Our results support the invasive management of patients with acute coronary syndrome to reduce short-term case-fatality.
- © 2011 by American Heart Association, Inc.