Vol 76, No 4 (2018)
Original articles
Published online: 2018-01-06

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Long-term prognosis following acute coronary syndromes: a prospective observational study of an unselected group treated in the 24/7 cardiac catheterisation laboratory at a university hospital

Marcin Grabowski1, Krzysztof J. Filipiak1, Grzegorz Opolski1, Renata Główczyńska1, Monika Gawałko1, Paweł Balsam1, Andrzej Cacko1, Zenon Huczek1, Grzegorz Karpiński1, Robert Kowalik1, Franciszek Majstrak2, Janusz Kochman1
Kardiol Pol 2018;76(4):755-763.

Abstract

Background: Risk stratification in acute coronary syndrome (ACS) is usually based on clinical data obtained during hospi-talisation. To date, there is a limited number of prospective observational studies assessing long-term prognosis of patients discharged from hospital after ACS.

Aim: This study is to investigate long-term follow-up of unselected ACS patients treated at the 24-hour/7-day (24/7) cardiac catheterisation laboratory and discharged from referral university hospital.

Methods: We studied 672 consecutive ACS patients (median age 61 years, 66.7% men) hospitalised and discharged be-tween 2002 and 2004. The analysis was done in respect of the type of ACS, i.e. non-ST-segment elevation: unstable angina non-ST-segment elevation myocardial infarction (UA/NSTEMI; n = 255) vs. ST-segment elevation myocardial infarction (STEMI; n = 417). All patients underwent coronarography and, if indicated, primary angioplasty (417 patients with STEMI and 157 pa-tients with UA/NSTEMI). The primary endpoint was defined as all-cause mortality during six years of follow-up. Survival status and date of death were obtained from the National Death Registry of Poland and presented as Kaplan-Meier survival curves.

Results: Despite a significantly higher one-year mortality of patients with UA/NSTEMI compared to those with STEMI (7.1% vs. 3.1%, p = 0.018), the overall mortality assessed throughout follow-up until 2009 was comparable between UA/NSTEMI and STEMI patients (18.8% vs. 18%, p = 0.79).

Conclusions: The long-term (several years) survival did not depend on the type of ACS.

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Polish Heart Journal (Kardiologia Polska)