Early predictors of 30-day mortality in non-ST-elevation acute coronary syndrome patients
Zgodnji dejavniki tveganja za 30-dnevno umrljivost bolnikov z akutnim koronarnim sindromom brez dviga veznice ST

english

2008

volume 77, issue 9

Acute Coronary Syndrome   Mortality   Risk Factors

Slovensko zdravniško društvo
(Obvezni izvod spletne publikacije)

Background. The incidence of non-ST-elevation acute coronary syndrome (ACS), including unstable angina pectoris and non-ST-elevation myocardial infarction (MI), is increasing in comparison to ST-elevation ACS. Our aim was to evaluate predictive role of admission variables for 30-day mortality in non-ST-elevation ACS patients. Patients and methods. We retrospectively analysed the data of 415 patients, admitted to University Clinical Center Maribor in 2006 due to non-ST-elevation ACS. Inclusion criteria were rest chest pain, ECG changes (ST-segment depression > or = 0.1 mV, and/or negative T wave > or = 0.1 mV and/or pathologic Q and/or non-specific ECG) and/or increased troponin T levels. Predictors of 30-day mortality were analysed by univariate and multivariate logistic regression. Results. 30-day mortality was 4.3 %. Between nonsurvivors and survivors there were significant differences in mean age, the incidence of arterial hypertension, positive family history of coronary artery disease, in mean admission systolic and diastolic blood pressure, pulse, mean admission troponin T, leukocyte count, CRP, creatinine and the incidence of admission heart failure. Multivariate logistic regression proved that most significant independent early predictor of 30-day mortality was admission heart failure (OR 41.21, 95 % CI 3.50 to 484.66, p = 0.003), followed by admission serum creatinine (OR 0.989, 95 % CI 0.981 to 0.997, p = 0.008) and troponin T (OR 0.263, 95 % CI 0.080 to 0.861). Conclusion. Most significant independent predictor of 30-day mortality of patients with non-ST-elevation ACS, being 4.5 %, was heart failure on admission.

16.09.2009