Intensive pharmacologic treatment in patients with acute non ST-segment elevation myocardial infarction who did not undergo percutaneous coronary intervention
Hae Chang Jeong, Young Keun Ahn, Myung Ho Jeong, Shung Chull Chae, Jong Hyun Kim, In Whan Seong, Young Jo Kim, Seung Ho Hur, Dong Hoon Choi, Taek Jong Hong, Jung Han Yoon, Jae Young Rhew, Jei Keon Chae, Doo Il Kim, In Ho Chae, Bon Kwon Koo, Byung Ok Kim, Nae Hee Lee, Jin Yong Hwang, Seok Kyu Oh, Myeong Chan Cho, Kee Sik Kim, Kyoung Tae Jeong, Myoung Yong Lee, Chong Jin Kim, Wook Sung Chung, Korea Acute Myocardial Infarction Registry Investigators, Myung Ho Jeong, Young Keun Ahn, Shung Chull Chae, Jong Hyun Kim, Seung Ho Hur, Young Jo Kim, In Whan Seong, Dong Hoon Choi, Jei Keon Chae, Taek Jong Hong, Jae Young Rhew, Doo Il Kim, In Ho Chae, Jung Han Yoon, Bon Kwon Koo, Byung Ok Kim, Myoung Yong Lee, Kee Sik Kim, Jin Yong Hwang, Myeong Chan Cho, Seok Kyu Oh, Nae Hee Lee, Kyoung Tae Jeong, Seung Jea Tahk, Jang Ho Bae, Seung Woon Rha, Keum Soo Park, Chong Jin Kim, Kyoo Rok Han, Tae Hoon Ahn, Moo Hyun Kim, Ki Bae Seung, Wook Sung Chung, Ju Young Yang, Chong Yun Rhim, Hyeon Cheol Gwon, Seong Wook Park, Young Youp Koh, Seung Jae Joo, Soo Joong Kim, Dong Kyu Jin, Jin Man Cho, Yang Soo Jang, Jeong Gwan Cho, Seung Jung Park, Hae Chang Jeong, Young Keun Ahn, Myung Ho Jeong, Shung Chull Chae, Jong Hyun Kim, In Whan Seong, Young Jo Kim, Seung Ho Hur, Dong Hoon Choi, Taek Jong Hong, Jung Han Yoon, Jae Young Rhew, Jei Keon Chae, Doo Il Kim, In Ho Chae, Bon Kwon Koo, Byung Ok Kim, Nae Hee Lee, Jin Yong Hwang, Seok Kyu Oh, Myeong Chan Cho, Kee Sik Kim, Kyoung Tae Jeong, Myoung Yong Lee, Chong Jin Kim, Wook Sung Chung, Korea Acute Myocardial Infarction Registry Investigators, Myung Ho Jeong, Young Keun Ahn, Shung Chull Chae, Jong Hyun Kim, Seung Ho Hur, Young Jo Kim, In Whan Seong, Dong Hoon Choi, Jei Keon Chae, Taek Jong Hong, Jae Young Rhew, Doo Il Kim, In Ho Chae, Jung Han Yoon, Bon Kwon Koo, Byung Ok Kim, Myoung Yong Lee, Kee Sik Kim, Jin Yong Hwang, Myeong Chan Cho, Seok Kyu Oh, Nae Hee Lee, Kyoung Tae Jeong, Seung Jea Tahk, Jang Ho Bae, Seung Woon Rha, Keum Soo Park, Chong Jin Kim, Kyoo Rok Han, Tae Hoon Ahn, Moo Hyun Kim, Ki Bae Seung, Wook Sung Chung, Ju Young Yang, Chong Yun Rhim, Hyeon Cheol Gwon, Seong Wook Park, Young Youp Koh, Seung Jae Joo, Soo Joong Kim, Dong Kyu Jin, Jin Man Cho, Yang Soo Jang, Jeong Gwan Cho, Seung Jung Park
Abstract
Background: The aim of this study was to assess the impact of more aggressive pharmacological treatment on short-term clinical outcomes in patients with acute non ST-segment elevation myocardial infarction (NSTEMI) who do not undergo percutaneous coronary intervention (PCI).
Methods and results: The 924 NSTEMI patients treated with early conservative strategy (69.2+/-12.5 years, 637 males) in 50 hospitals that were high-volume centers with facilities for primary PCI were recruited to the Korean Acute Myocardial Infarction Registry (KAMIR) from November 2005 to August 2007. For all patients, the pharmacotherapy index based on the use of drugs during hospital stay was assessed (range of points 0-10). Primary endpoint was the combined in-hospital mortality and morbidity and major adverse cardiac events during 1 month of clinical follow-up. Of the patients, data from 847 who were followed-up for 1 month after discharge were analyzed. The rate of the primary endpoint decreased with an increase of the pharmacotherapy index and this result was similar in the low- and high-risk groups. In the multivariate analysis, low pharmacotherapy index (<or=4 points) was an independent predictor of the primary endpoint.
Conclusions: More intensive pharmacological treatment may improve short-term clinical outcomes in acute NSETMI patients who do not undergo PCI.
Source: PubMed