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The Korean Journal of Medicine 2009;77(5): 582-592.
급성 ST 분절 상승과 ST 분절 비상승 심근경색증 환자의 예후 비교
김민철, 안영근, 조경훈, 박동진, 김현국, 김성수, 정해창, 조재영, 박근호, 심두선, 윤남식, 윤현주, 김계훈, 홍영준, 박형욱, 김주한, 정명호, 조정관, 박종춘, 강정채
Comparison of the prognosis of patients with acute ST-elevation and non-ST-elevation myocardial infarction
Min Chul Kim, Youngkeun Ahn, Kyung Hun Cho, Dong Jin Park, Hyun Kuk Kim, Sung Soo Kim, Hae Chang Jeong, Jae Young Cho, Keun Ho Park, Doo Sun Sim, Nam Sik Yoon, Hyun Ju Yoon, Kye Hun Kim, Young Joon Hong, Hyung Wook Park, Ju Han Kim, Myung Ho Jeong, Jeong Gwan Cho, Jong Chun Park, Jung Chaee Kang
ABSTRACT
Background/Aims:
Acute ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) have different therapeutic strategies. This study assessed the risk factors, therapeutic strategies, clinical outcomes, and prognostic factors of STEMI and NSTEMI.
Methods:
Patients admitted to our hospital with a diagnosis of acute myocardial infarction between November 2005 and December 2006 were evaluated. We analyzed their baseline clinical characteristics, angiographic characteristics, in-hospital mortality, and major adverse cardiac events (MACE) during clinical follow-up for 1 year in patients with STEMI and NSTEMI.
Results:
There were 447 STEMI patients and 186 NSTEMI patients. Smoking was the most common risk factor in both groups. In the STEMI group, primary percutaneous coronary intervention was performed in 85.0% and thrombolysis was performed in 7.2% of the patients. In the NSTEMI group, an early invasive strategy was chosen in 66.7% of the patients. The in-hospital mortality rate was 3.8% in the STEMI group and 3.2% in the NSTEMI group. The rates of MACE at 6 months and 1 year did not differ significantly between the groups (17.7% vs. 17.3% and 22.8% vs. 20.2%, respectively). Independent predictors of prognosis were diabetes mellitus, smoking, and left ventricular ejection fraction (LVEF) <40% on admission in the NSTEMI group, and serum troponin I in the STEMI group. Troponin I was the only predictor of prognosis in the STEMI group (p=0.047 vs. p=0.139).
Conclusions:
Patients with STEMI and NSTEMI had similar clinical outcomes during a 1-year clinical follow-up. Of the predictors of prognosis, troponin I is the only one in STEMI.
Keywords: Photodynamic; Lung cancer
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