Why some patients with acute coronary syndrome hospitalized in
a university tertiary centre do not undergo coronary
angiography? Results from the AHEAD-ACS registry

J 2014

Why some patients with acute coronary syndrome hospitalized in a university tertiary centre do not undergo coronary angiography? Results from the AHEAD-ACS registry

FELŠŐCI, Marián; M. HOLICKÁ; Jiří PAŘENICA; Jiří JARKOVSKÝ; Roman MIKLÍK et al.

Základní údaje

Originální název

Why some patients with acute coronary syndrome hospitalized in a university tertiary centre do not undergo coronary angiography? Results from the AHEAD-ACS registry

Autoři

FELŠŐCI, Marián; M. HOLICKÁ; Jiří PAŘENICA; Jiří JARKOVSKÝ ; Roman MIKLÍK; K. HOŘÁKOVÁ a Jindřich ŠPINAR

Vydání

Cor et Vasa, Brno, Česká kardiologická společnost, 2014, 0010-8650

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Česká republika

Utajení

není předmětem státního či obchodního tajemství

Označené pro přenos do RIV

Ano

Kód RIV

RIV/00216224:14110/14:00080045

Organizační jednotka

Lékařská fakulta

Klíčová slova anglicky

Acute heart failure; Coronary angiography; Myocardial infarction; Prognosis

Štítky

EL OK

Příznaky

Recenzováno

Změněno: 10. 4. 2015 14:40, Ing. Mgr. Věra Pospíšilíková

Anotace

V originále

Background To evaluate in-hospital and long-term mortality of patients with acute coronary syndromes (ACS) not having selective coronary angiography (CAG) during hospitalization and to analyze the reasons for conservative approach. Methods and patients A single-centre retrospective study using registry data. Over the period from January 2005 to April 2009, a total of 193 ACS patients did not have in-hospital CAG. Fifty-five (28.5%) patients had recent CAG (within the last 12 months) or the procedure was planned after discharge (invasive group "I"). In 138 (71.5%) patients, CAG was not considered at all (conservative approach, group "C"). These subgroups were compared in terms of in-hospital parameters and long-term mortality. Results ST-segment elevation myocardial infarction (STEMI) was diagnosed in 50 (25.9%) patients. The most frequent reasons for not performing CAG included serious comorbidities affecting the prognosis (22%) and pharmacological stabilization in very old individuals with non-STEMI (21%). One in ten (11%) patients died before the CAG was performed, the same proportion of patients refused to have CAG or had a long ischaemia time (STEMI subgroup). A temporary contraindication to CAG was found in 8%, a recent CAG finding not suitable for revascularization in 8%, while a limiting neurological disease was present in 6% of patients. In-hospital mortality was 30.1%, being higher in Group C (34.1% vs. 20.0%; p = 0.049), 6-year mortality was as high as 78.8%, also with higher rates in Group C (86.2% vs. 60.2%; p < 0.001). Patients receiving conservative therapy were older, with a higher proportion of limiting comorbidities that contraindicated CAG, and had a more serious course of hospitalization. Conclusion The most common reasons for not performing CAG in ACS patients included advanced age, serious and often extra-cardiac comorbidities, and a complicated hospitalization course. The short- and long-term mortality rates in these patients are high.

Citovat

FELŠŐCI, Marián; M. HOLICKÁ; Jiří PAŘENICA; Jiří JARKOVSKÝ; Roman MIKLÍK; K. HOŘÁKOVÁ a Jindřich ŠPINAR. Why some patients with acute coronary syndrome hospitalized in a university tertiary centre do not undergo coronary angiography? Results from the AHEAD-ACS registry. Cor et Vasa. Brno: Česká kardiologická společnost, 2014, roč. 56, č. 4, s. "e369"-"e375", 7 s. ISSN 0010-8650. Dostupné z: https://doi.org/10.1016/j.crvasa.2014.05.005.

@article{1297439,
   author = {Felšőci, Marián and Holická, M. and Pařenica, Jiří and Jarkovský, Jiří and Miklík, Roman and Hořáková, K. and Špinar, Jindřich},
   article_location = {Brno},
   article_number = {4},
   doi = {https://doi.org/10.1016/j.crvasa.2014.05.005},
   keywords = {Acute heart failure; Coronary angiography; Myocardial infarction; Prognosis},
   language = {eng},
   issn = {0010-8650},
   journal = {Cor et Vasa},
   title = {Why some patients with acute coronary syndrome hospitalized in a university tertiary centre do not undergo coronary angiography? Results from the AHEAD-ACS registry},
   volume = {56},
   year = {2014}
}

TY  - JOUR
ID  - 1297439
AU  - Felšőci, Marián - Holická, M. - Pařenica, Jiří - Jarkovský, Jiří - Miklík, Roman - Hořáková, K. - Špinar, Jindřich
PY  - 2014
TI  - Why some patients with acute coronary syndrome hospitalized in a university tertiary centre do not undergo coronary angiography? Results from the AHEAD-ACS registry
JF  - Cor et Vasa
VL  - 56
IS  - 4
SP  - "e369"-"e375"
EP  - "e369"-"e375"
PB  - Česká kardiologická společnost
SN  - 00108650
KW  - Acute heart failure
KW  - Coronary angiography
KW  - Myocardial infarction
KW  - Prognosis
N2  - Background To evaluate in-hospital and long-term mortality of patients with acute coronary syndromes (ACS) not having selective coronary angiography (CAG) during hospitalization and to analyze the reasons for conservative approach. Methods and patients A single-centre retrospective study using registry data. Over the period from January 2005 to April 2009, a total of 193 ACS patients did not have in-hospital CAG. Fifty-five (28.5%) patients had recent CAG (within the last 12 months) or the procedure was planned after discharge (invasive group "I"). In 138 (71.5%) patients, CAG was not considered at all (conservative approach, group "C"). These subgroups were compared in terms of in-hospital parameters and long-term mortality. Results ST-segment elevation myocardial infarction (STEMI) was diagnosed in 50 (25.9%) patients. The most frequent reasons for not performing CAG included serious comorbidities affecting the prognosis (22%) and pharmacological stabilization in very old individuals with non-STEMI (21%). One in ten (11%) patients died before the CAG was performed, the same proportion of patients refused to have CAG or had a long ischaemia time (STEMI subgroup). A temporary contraindication to CAG was found in 8%, a recent CAG finding not suitable for revascularization in 8%, while a limiting neurological disease was present in 6% of patients. In-hospital mortality was 30.1%, being higher in Group C (34.1% vs. 20.0%; p = 0.049), 6-year mortality was as high as 78.8%, also with higher rates in Group C (86.2% vs. 60.2%; p < 0.001). Patients receiving conservative therapy were older, with a higher proportion of limiting comorbidities that contraindicated CAG, and had a more serious course of hospitalization. Conclusion The most common reasons for not performing CAG in ACS patients included advanced age, serious and often extra-cardiac comorbidities, and a complicated hospitalization course. The short- and long-term mortality rates in these patients are high.
ER  -

FELŠ$\backslash$H OCI, Marián; M. HOLICKÁ; Jiří PAŘENICA; Jiří JARKOVSKÝ; Roman MIKLÍK; K. HOŘÁKOVÁ a Jindřich ŠPINAR. Why some patients with acute coronary syndrome hospitalized in a university tertiary centre do not undergo coronary angiography? Results from the AHEAD-ACS registry. \textit{Cor et Vasa}. Brno: Česká kardiologická společnost, 2014, roč.~56, č.~4, s.~''e369''-''e375'', 7 s. ISSN~0010-8650. Dostupné z: https://doi.org/10.1016/j.crvasa.2014.05.005.

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