Heart Views

ORIGINAL ARTICLE
Year
: 2007  |  Volume : 8  |  Issue : 1  |  Page : 10--16

Are patients with Non-ST elevation myocardial infarction undertreated?


Saman Rasoul1, Jan Paul Ottervanger1, Jan-Henk E Dambrink1, Menko-Jan de Boer1, Jan CA Hoorntje1, AT Marcel Gosselink1, Felix Zijlstra2, Harry Suryapranata1, Arnoud WJ van't Hof1 
1 Isala Klinieken, Dept of Cardiology, Zwolle, The Netherlands, Netherlands
2 University Medical Center Groningen, University of Groningen, The Netherlands, Netherlands

Correspondence Address:
Saman Rasoul
Isala Klinieken, Dept of Cardiology, Zwolle, The Netherlands
Netherlands

Background: The worse prognosis in patients without ST-elevation (non-STEMI) as compared to ST-elevation myocardial infarction (STEMI) may be due to treatment differences. We aimed to evaluate the differences in characteristics, treatment and outcome in patients with non-STEMI versus STEMI in an unselected patient population. Methods: Individual patient data from all patients in our hospital with a discharge diagnosis of MI between January 2001 and January 2002 were evaluated. Follow-up data were obtained until December 2004. Patients were categorized according to the presenting electrocardiogram into non-STEMI or STEMI. Results: A total of 824 patients were discharged with a diagnosis of MI, 29% with non-STEMI and 71% with STEMI. Patients with non-STEMI were significantly older and had a higher cardiovascular risk profile. They underwent less frequently coronary angiography and revascularization and received less often clopidogrel and ACE-inhibitor on discharge. Long-term mortality was significantly higher in the non-STEMI patients as compared to STEMI patients, 20% vs 12%, p = 0.006, respectively. However, multivariate analysis showed that age, diabetes, hypertension and no reperfusion therapy (but not non-STEMI presentation) were independent and significant predictors of long-term mortality. Conclusion : In an unselected cohort of patients discharged with MI, there were significant differences in baseline characteristics, and (invasive) treatment between STEMI and non-STEMI. Long-term mortality was also different, but this was due to differences in baseline characteristics and treatment. More aggressive treatment may improve outcome in non-STEMI patients.


How to cite this article:
Rasoul S, Ottervanger JP, Dambrink JHE, de Boer MJ, Hoorntje JC, Gosselink AM, Zijlstra F, Suryapranata H, van't Hof AW. Are patients with Non-ST elevation myocardial infarction undertreated?.Heart Views 2007;8:10-16


How to cite this URL:
Rasoul S, Ottervanger JP, Dambrink JHE, de Boer MJ, Hoorntje JC, Gosselink AM, Zijlstra F, Suryapranata H, van't Hof AW. Are patients with Non-ST elevation myocardial infarction undertreated?. Heart Views [serial online] 2007 [cited 2021 Apr 20 ];8:10-16
Available from: https://www.heartviews.org/article.asp?issn=1995-705X;year=2007;volume=8;issue=1;spage=10;epage=16;aulast=Rasoul;type=0