Author/Editor     Rožič, Suzana; Županić, Melanija; Sinkovič, Andreja
Title     Early predictors of 30-day mortality in non-ST-elevation acute coronary syndrome patients
Translated title     Zgodnji dejavniki tveganja za 30-dnevno umrljivost bolnikov z akutnim koronarnim sindromom brez dviga veznice ST
Type     članek
Source     Zdrav Vestn
Vol. and No.     Letnik 77, št. 9
Publication year     2008
Volume     str. 553-60
Language     eng
Abstract     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.
Summary     Izhodišča. Akutni korornarni sindrom (AKS) brez dviga veznice ST je vse pogostejši. Naš cilj je oceniti pomen zgodnjih dejavnikov za smrt znotraj 30 dni pri bolnikih z AKS brez dviga veznice ST. Bolniki in metode. Retrospektivno smo obdelali podatke 415 bolnikov, sprejetih v 2006 v Univerzitetni klinični center Maribor zaradi AKS brez dviga veznice ST. Ob prsni bolečini v mirovanju so imeli bolniki značilne EKG spremembe (znižanje veznice ST več ali enako 0,1 mV in/ali negativni val T večji ali enak 0,1 mV in/ali patološki val Q in/ali nespecifični EKG) in/ali dvig troponina T. Zgodnja napovedna vrednost spremenljivk za 30-dnevno umrljivost je bila ocenjena z univariantno in multivariantno statistično metodo. Rezultati. 30-dnevna umrljivost je bila 4,3 %. Med umrlimi in preživelimi smo ugotavljali statistično pomembne razlike v povprečni starosti, pogostnosti arterijske hipertenzije, pozitivne družinske anamneze koronarne koronarne bolezni, povprečni vrednosti sprejemnega sistoličnega in diastoličnega krvnega tlaka, pulza, troponina T, števila levkocitov, CRP in kreatinina ter vpogostnosti srčnega popuščanja ob sprejemu. Multivariantna logistična regresija je pokazala, da je najpomembnejši zgodnji dejavnik tveganja za 30-dnevno umrljivost prisotnost srčnega popuščanja ob sprejemu (OR 41,21,95 % CI 3,50 do 484,66, p=0,003), nato sprejemna vrednost kreatinina (OR 0,989, 95 % CI 0,981 do 0,997, p=0,008) in troponina T (OR 0,263,95 % CI 0,080 do 0,861, p=0,027). Zaključki. Najpomembnejši neodvisni dejavnik tveganja za 30-dnevno umrljivost bolnikov z AKS brez trajnega dviga veznice ST, ki je bila 4,3 %, je prisotnost srčnega popuščanja ob sprejemu v bolnišnico.
Descriptors     MORTALITY
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