ASSA14-01-06One-year outcomes in Chinese patients with acute coronary syndromes: a subanalysis of EPICOR Asia study

• Published in: Heart (British Cardiac Society) Vol. 101; no. Suppl 1; pp. A2 - A3
• Main Authors: Huo, Y, Han, Y L, Ge, J B, Chen, J Y, Yuan, Z Y, Qiao, S B, Yu, B
• Format: Journal Article
• Language: English
• Published: 01.01.2015
• ISSN: 1355-6037; 1468-201X
• DOI: 10.1136/heartjnl-2014-307109.6

ObjectivesThe outcomes of Chinese patients with acute coronary syndromes (ACS) remain unclear. This study aimed to investigate the 1-year outcomes of Chinese patients with ST segment elevation myocardial infarction (STEMI), non-STEMI (NSTEMI) and unstable angina (UA).MethodsThis is a subanalysis of Long-tErm follow-uP of antithrombotic management patterns In Acute CORonary Syndrome patients in Asia (EPICOR Asia) study (NCT01361386), a prospective, multinational, observational study on ACS patients after discharge with 2-year follow-up. One-year follow-up outcomes of Chinese patients with ACS were reported based on the final diagnosis of STEMI, NSTEMI or UA, which were confirmed by an independent validation committee.ResultsEight thousand two hundred and fourteen Chinese patients with ACS were finally included in this study (STEMI, n = 3961; NSTEMI, n = 1315; UA, n = 2938). The baseline characteristics of patients were reported in Table 1. The one-year incidences of cardiovascular/cerebrovascular event (20.5%), congestive heart failure (2.1%), primary ischaemic stroke (1.4%), and death (3.7%) were highest in patients with NSTEMI (overall p < 0.01 vs STEMI) (Table 2). Additionally, the mortality of patients with UA was significantly lower than that of STEMI patients (p < 0.001). The one-year incidence of bleeding event is the same in STEMI and NSTEMI patients. The accumulated mortality in patients with STEMI, NSTEMI and UA all increased with one year follow-up (Figure 1).CharacteristicsSTEMI (n = 3961)NSTEMI (n = 1315)UA (n = 2938)Total (n = 8214)Age, mean (SD), year59 (12)63 (12)62 (10)61 (11)Male, % (n)81.6 (3231)72.7 (956)66.3 (1948)74.7 (6135)BMI, mean (SD), kg/m2 24.6 (3.3)24.7 (3.5)24.9 (3.6)24.7 (3.5)Place of residence Rural, % (n)33.7 (1333)28.0 (368)31.1 (913)31.8 (2614)Metropolitan, % (n)66.3 (2628)72.0 (947)68.9 (2025)68.2 (5600)Medical history Hypertension, % (n)49.2 (1950)60.7 (798)63.6 (1869)56.2 (4617)Diabetes Mellitus, % (n)20.0 (794)25.9(340)24.0 (706)22.4 (1840)CAD family history, % (n)9.3 (370)9.5 (125)9.2 (269)9.3 (764)CVD history, % (n)20.7 (820)34.1 (449)46.2 (1356)32.0 (2625)Chronic medication Any antiplatelet, % (n)15.0 (593)26.0 (342)43.0 (1263)26.8 (2198)Any anticoagulant, % (n)0.7 (26)0.6 (8)0.7 (21)0.7 (55)Any diabetes therapy, % (n)12.4 (490)17.0 (223)16.3 (478)14.5 (1191)Any CV therapy, % (n)19.7 (781)32.8 (431)42.3 (1242)29.9 (2454)SD: standard deviation; BMI: Body Mass Index; CAD: coronary artery disease; CVD: cardiovascular disease; CV: cardiovascular.Abstract ASSA14-01-06 Table 2 One-year post-discharge outcomes of patients by final diagnosisOutcomesSTEMI (n = 3961)NSTEMI (n = 1315)UA (n = 2938)Total (n = 8214)Cardiovascular/cerebrovascular event, % (n)17.3 (685)20.5 (270)*19.1 (560)18.4 (1515)NSTEMI, %(n)0.6 (25)3.2 (42)***0.6 (18)1.0 (85)STEMI, %(n)2.1 (82)1.2 (16)0.4 (13)***1.4 (111)Cardiac arrhythmia, % (n)0.3 (13)0.2 (2)0.6 (17)0.4 (32)Congestive heart failure, % (n)1.8 (71)2.1 (28)0.9 (26)*1.5 (125)Primary ischemic stroke, % (n)0.6 (24)1.4 (19)*1.1 (32)+ 0.9 (75)Bleeding event, % (n)3.9 (154)3.9 (51)3.7 (108)3.8 (313)Thrombo-embolic event, % (n)10.1 (399)11.6 (153)12.4 (364)*11.2 (916)Death, % (n)3.1 (124)3.7 (48)1.8 (54)**2.8 (226)Patients with multiple events in the same category are counted only once in that category. Patients with events in more than one category are counted once in each of those categories.+p < 0.05 vs STEMI*p < 0.01 vs STEMI**p < 0.001 vs STEMI***p < 0.0001 vs STEMI.[Figure]ConclusionThe outcomes of Chinese patients with NSTEMI were poorer than that of STEMI and UA. Therefore, further studies are needed to identify ideal therapeutic algorithm for these patients in China.