Late Consequences of Acute Coronary Syndromes: Global Registry of Acute Coronary Events (GRACE)Follow-up
Am. j. med
; 128(7): 766-775, 2015. ilus
Article
in English
| Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP
| ID: biblio-1059511
Responsible library:
BR79.1
Localization: BR79.1
ABSTRACT
PURPOSE:
Short-term outcomes have been well characterized in acute coronary syndromes; however,longer-term follow-up for the entire spectrum of these patients, including ST-segment-elevation myocardialinfarction, non-ST-segment-elevation myocardial infarction, and unstable angina, is more limited. Therefore,we describe the longer-term outcomes, procedures, and medication use in Global Registry of AcuteCoronary Events (GRACE) hospital survivors undergoing 6-month and 2-year follow-up, and the performanceof the discharge GRACE risk score in predicting 2-year mortality.METHODS:
Between 1999 and 2007, 70,395 patients with a suspected acute coronary syndrome wereenrolled. In 2004, 2-year prospective follow-up was undertaken in those with a discharge acute coronarysyndrome diagnosis in 57 sites.RESULTS:
From 2004 to 2007, 19,122 (87.2%) patients underwent follow-up; by 2 years postdischarge,14.3% underwent angiography, 8.7% percutaneous coronary intervention, 2.0% coronary bypass surgery,and 24.2% were re-hospitalized. In patients with 2-year follow-up, acetylsalicylic acid (88.7%), betablocker(80.4%), renin-angiotensin system inhibitor (69.8%), and statin (80.2%) therapy was used. Heartfailure occurred in 6.3%, (re)infarction in 4.4%, and death in 7.1%. Discharge-to-6-month GRACE riskscore was highly predictive of all-cause mortality at 2 years (c-statistic 0.80).CONCLUSION:
In this large multinational cohort of acute coronary syndrome patients, there were importantlater adverse consequences, including frequent morbidity and mortality. These findings were seen in thecontext of additional coronary procedures and despite continued use of evidence-based therapies in a highproportion of patients. The discriminative accuracy of the GRACE risk score in hospital survivors forpredicting longer-term mortality was maintained.
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Collection:
National databases
/
Brazil
Database:
Sec. Est. Saúde SP
/
SESSP-IDPCPROD
Main subject:
Acute Coronary Syndrome
/
Myocardial Infarction
/
Myocardial Revascularization
Type of study:
Prognostic study
Language:
English
Journal:
Am. j. med
Year:
2015
Document type:
Article
Institution/Affiliation country:
Canadian Heart Research Centre/CA
/
Centre Hospitalier Universitaire Pitié-Salpêtrière/FR
/
Concord Hospital and University of Sydney/AU
/
Department of Cardiology, KKO St Marien Hospital/DE
/
Duke University Medical Center/US
/
Hoag Memorial Hospital Presbyterian/US
/
Hospital Universitario La Paz/ES
/
ICYCC Favaloro Foundation/AR
/
Instituto Dante Pazzanese de Cardiologia/BR
/
Postgraduate Medical School, Grochowski Hospital/PL