Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Clinical Investigation
Intensive Pharmacologic Treatment in Patients With Acute Non ST-Segment Elevation Myocardial Infarction Who Did Not Undergo Percutaneous Coronary Intervention
Hae Chang JeongYoung Keun AhnMyung Ho JeongShung Chull ChaeJong Hyun KimIn Whan SeongYoung Jo KimSeung Ho HurDong Hoon ChoiTaek Jong HongJung Han YoonJae Young RhewJei Keon ChaeDoo Il KimIn Ho ChaeBon Kwon KooByung Ok KimNae Hee LeeJin Yong HwangSeok Kyu OhMyeong Chan ChoKee Sik KimKyoung Tae JeongMyoung Yong LeeChong Jin KimWook Sung ChungKorea Acute Myocardial Infarction Registry Investigators
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2008 Volume 72 Issue 9 Pages 1403-1409

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Abstract

Background The aim of this study was to assess the impact of more aggressive pharmacological treatment on short-term clinical outcomes in patients with acute non ST-segment elevation myocardial infarction (NSTEMI) who do not undergo percutaneous coronary intervention (PCI). Methods and Results The 924 NSTEMI patients treated with early conservative strategy (69.2±12.5 years, 637 males) in 50 hospitals that were high-volume centers with facilities for primary PCI were recruited to the Korean Acute Myocardial Infarction Registry (KAMIR) from November 2005 to August 2007. For all patients, the pharmacotherapy index based on the use of drugs during hospital stay was assessed (range of points 0-10). Primary endpoint was the combined in-hospital mortality and morbidity and major adverse cardiac events during 1 month of clinical follow-up. Of the patients, data from 847 who were followed-up for 1 month after discharge were analyzed. The rate of the primary endpoint decreased with an increase of the pharmacotherapy index and this result was similar in the low- and high-risk groups. In the multivariate analysis, low pharmacotherapy index (≤4 points) was an independent predictor of the primary endpoint. Conclusions More intensive pharmacological treatment may improve short-term clinical outcomes in acute NSETMI patients who do not undergo PCI. (Circ J 2008; 72: 1403 - 1409)

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© 2008 THE JAPANESE CIRCULATION SOCIETY
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