skip to main content
Idioma:

Guideline-indicated treatments and diagnostics, GRACE risk score, and survival for non-ST elevation myocardial infarction

Hall, Marlous ; Bebb, Owen J ; Dondo, Tatandashe B ; Yan, Andrew T ; Goodman, Shaun G ; Bueno, Hector ; Chew, Derek P ; Brieger, David ; Batin, Philip D ; Farkouh, Michel E ; Hemingway, Harry ; Timmis, Adam ; Fox, Keith A A ; Gale, Chris P

European heart journal, 2018-11, Vol.39 (42), p.3798-3806 [Periódico revisado por pares]

England: Oxford University Press

Texto completo disponível

Citações Citado por
  • Título:
    Guideline-indicated treatments and diagnostics, GRACE risk score, and survival for non-ST elevation myocardial infarction
  • Autor: Hall, Marlous ; Bebb, Owen J ; Dondo, Tatandashe B ; Yan, Andrew T ; Goodman, Shaun G ; Bueno, Hector ; Chew, Derek P ; Brieger, David ; Batin, Philip D ; Farkouh, Michel E ; Hemingway, Harry ; Timmis, Adam ; Fox, Keith A A ; Gale, Chris P
  • Assuntos: Clinical Research
  • É parte de: European heart journal, 2018-11, Vol.39 (42), p.3798-3806
  • Notas: ObjectType-Article-1
    SourceType-Scholarly Journals-1
    ObjectType-Feature-2
    content type line 23
    ObjectType-Undefined-3
    Marlous Hall and Owen J. Bebb authors are joint first authors.
  • Descrição: Abstract Aims To investigate whether improved survival from non-ST-elevation myocardial infarction (NSTEMI), according to GRACE risk score, was associated with guideline-indicated treatments and diagnostics, and persisted after hospital discharge. Methods and results National cohort study (n = 389 507 patients, n = 232 hospitals, MINAP registry), 2003–2013. The primary outcome was adjusted all-cause survival estimated using flexible parametric survival modelling with time-varying covariates. Optimal care was defined as the receipt of all eligible treatments and was inversely related to risk status (defined by the GRACE risk score): 25.6% in low, 18.6% in intermediate, and 11.5% in high-risk NSTEMI. At 30 days, the use of optimal care was associated with improved survival among high [adjusted hazard ratio (aHR) −0.66 95% confidence interval (CI) 0.53–0.86, difference in absolute mortality rate (AMR) per 100 patients (AMR/100–0.19 95% CI −0.29 to −0.08)], and intermediate (aHR = 0.74, 95% CI 0.62–0.92; AMR/100 = −0.15, 95% CI −0.23 to −0.08) risk NSTEMI. At the end of follow-up (8.4 years, median 2.3 years), the significant association between the use of all eligible guideline-indicated treatments and improved survival remained only for high-risk NSTEMI (aHR = 0.66, 95% CI 0.50–0.96; AMR/100 = −0.03, 95% CI −0.06 to −0.01). For low-risk NSTEMI, there was no association between the use of optimal care and improved survival at 30 days (aHR = 0.92, 95% CI 0.69–1.38) and at 8.4 years (aHR = 0.71, 95% CI 0.39–3.74). Conclusion Optimal use of guideline-indicated care for NSTEMI was associated with greater survival gains with increasing GRACE risk, but its use decreased with increasing GRACE risk.
  • Editor: England: Oxford University Press
  • Idioma: Inglês
Links
Voltar para lista de resultados
Ir para página anteriorAnterior Resultado  8 AvançarIr para próxima página

  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

Buscando em bases de dados remotas. Favor aguardar.