Intensive Pharmacologic Treatment in Patients With Acute Non ST-Segment Elevation Myocardial Infarction Who Did Not Undergo Percutaneous Coronary Intervention

• Published in: Circulation Journal Vol. 72; no. 9; pp. 1403 - 1409
• Main Authors: Jeong, Hae Chang, Ahn, Young Keun, Jeong, Myung Ho, Chae, Shung Chull, Kim, Jong Hyun, Seong, In Whan, Kim, Young Jo, Hur, Seung Ho, Choi, Dong Hoon, Hong, Taek Jong, Yoon, Jung Han, Rhew, Jae Young, Chae, Jei Keon, Kim, Doo Il, Chae, In Ho, Koo, Bon Kwon, Kim, Byung Ok, Lee, Nae Hee, Hwang, Jin Yong, Oh, Seok Kyu, Cho, Myeong Chan, Kim, Kee Sik, Jeong, Kyoung Tae, Lee, Myoung Yong, Kim, Chong Jin, Chung, Wook Sung, Korea Acute Myocardial Infarction Registry Investigators
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Circulation Society 2008
• Subjects: Aged; Aged, 80 and over; Cardiac Catheterization; Drugs; Female; Follow-Up Studies; Hospital Mortality; Humans; Korea - epidemiology; Male; Middle Aged; Myocardial infarction; Myocardial Infarction - drug therapy; Myocardial Infarction - mortality; Non ST-segment elevation; Prognosis; Retrospective Studies; Risk Factors; Survival Rate; Korea
• ISSN: 1346-9843; 1347-4820
• DOI: 10.1253/circj.CJ-08-0048

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 (≤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. (Circ J 2008; 72: 1403 - 1409)