open access

Vol 27, No 5 (2020)
Original articles — Clinical cardiology
Published online: 2018-11-06
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Impact of routine invasive strategy on outcomes in patients with non-ST-segment elevation myocardial infarction during 2005–2014: A report from the Polish Registry of Acute Coronary Syndromes (PL-ACS)

Łukasz Piątek, Krzysztof Wilczek, Jacek Kurzawski, Marek Gierlotka, Mariusz Gąsior, Lech Poloński, Marcin Sadowski
DOI: 10.5603/CJ.a2018.0136
·
Pubmed: 30406936
·
Cardiol J 2020;27(5):583-589.

open access

Vol 27, No 5 (2020)
Original articles — Clinical cardiology
Published online: 2018-11-06

Abstract

Background: Non-ST-segment elevation myocardial infarction (NSTEMI) has become the most frequently encountered type of myocardial infarction. The patient clinical profile and management has evolved over the past decade. As there is still a scarcity of data on the latest trends in NSTEMI, changes herein were observed and assessed in the treatment and outcomes in Poland between 2005 and 2014.

Methods:
A total of 197,192 patients with NSTEMI who enrolled in the Polish Registry of Acute Coronary Syndromes (PL-ACS) between 2005 and 2014 were analyzed. In-hospital and 12-month mortality were assessed.

Results:
Coronary angiography use increased from 35.8% in 2005–2007 to 90.7% in 2012–2014 (p < 0.05), whereas percutaneous coronary intervention increased from 25.7% in 2005–2007 to 63.6% in 2012–2014 (p < 0.05). There was a 50% reduction in in-hospital mortality (from 5.6% in 2005–2007 to 2.8% in 2012–2014; p < 0.05) and a 30% reduction in 1-year mortality (from 19.4% in 2005–2007 to 13.7% in 2012–2014; p < 0.05). A multivariate analysis confirmed an immense impact of invasive strategy on patient prognosis during in-hospital observation with an odds ratio (OR) of 0.31 (95% confidence interval [CI] 0.29–0.33; p < 0.05) as well as during the 12-month observation with an OR of 0.51 (95% CI 0.49–0.52; p < 0.05).

Conclusions:
Over the past 10 years, an important advance in the management of NSTEMI has taken place in Poland. Routine invasive strategy resulted in a significant decrease in mortality rates in all groups of NSTEMI patients.

Abstract

Background: Non-ST-segment elevation myocardial infarction (NSTEMI) has become the most frequently encountered type of myocardial infarction. The patient clinical profile and management has evolved over the past decade. As there is still a scarcity of data on the latest trends in NSTEMI, changes herein were observed and assessed in the treatment and outcomes in Poland between 2005 and 2014.

Methods:
A total of 197,192 patients with NSTEMI who enrolled in the Polish Registry of Acute Coronary Syndromes (PL-ACS) between 2005 and 2014 were analyzed. In-hospital and 12-month mortality were assessed.

Results:
Coronary angiography use increased from 35.8% in 2005–2007 to 90.7% in 2012–2014 (p < 0.05), whereas percutaneous coronary intervention increased from 25.7% in 2005–2007 to 63.6% in 2012–2014 (p < 0.05). There was a 50% reduction in in-hospital mortality (from 5.6% in 2005–2007 to 2.8% in 2012–2014; p < 0.05) and a 30% reduction in 1-year mortality (from 19.4% in 2005–2007 to 13.7% in 2012–2014; p < 0.05). A multivariate analysis confirmed an immense impact of invasive strategy on patient prognosis during in-hospital observation with an odds ratio (OR) of 0.31 (95% confidence interval [CI] 0.29–0.33; p < 0.05) as well as during the 12-month observation with an OR of 0.51 (95% CI 0.49–0.52; p < 0.05).

Conclusions:
Over the past 10 years, an important advance in the management of NSTEMI has taken place in Poland. Routine invasive strategy resulted in a significant decrease in mortality rates in all groups of NSTEMI patients.

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Keywords

non-ST-elevation myocardial infarction, invasive strategy, percutaneous coronary intervention, outcomes, temporal trends

About this article
Title

Impact of routine invasive strategy on outcomes in patients with non-ST-segment elevation myocardial infarction during 2005–2014: A report from the Polish Registry of Acute Coronary Syndromes (PL-ACS)

Journal

Cardiology Journal

Issue

Vol 27, No 5 (2020)

Pages

583-589

Published online

2018-11-06

DOI

10.5603/CJ.a2018.0136

Pubmed

30406936

Bibliographic record

Cardiol J 2020;27(5):583-589.

Keywords

non-ST-elevation myocardial infarction
invasive strategy
percutaneous coronary intervention
outcomes
temporal trends

Authors

Łukasz Piątek
Krzysztof Wilczek
Jacek Kurzawski
Marek Gierlotka
Mariusz Gąsior
Lech Poloński
Marcin Sadowski

References (14)
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