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KMID : 0882420090770050582
Korean Journal of Medicine
2009 Volume.77 No. 5 p.582 ~ p.592
Comparison of the prognosis of patients with acute ST-elevation and non-ST-elevation myocardial infarction
Kim Min-Chul

Ahn Young-Keun
Cho Kyung-Hoon
Park Dong-Jin
Kim Hyun Kuk
Kim Sung-Soo
Jeong Hae-Chang
Cho Jae-Yeong
Park Keun-Ho
Sim Doo-Sun
Yoon Nam-Sik
Yoon Hyun-Ju
Kim Kye-Hun
Hong Young-Joon
Park Hyung-Wook
Kim Ju-Han
Jeong Myung-Ho
Cho Jeong-Gwan
Park Jong-Chun
Kang Jung-Chaee
Abstract
Background/Aims: Acute ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) have different therapeutic strategies. This study assessed the risk factors, therapeutic strategies, clinical outcomes, and prognostic factors of STEMI and NSTEMI.

Methods: Patients admitted to our hospital with a diagnosis of acute myocardial infarction between November 2005 and December 2006 were evaluated. We analyzed their baseline clinical characteristics, angiographic characteristics, in-hospital mortality, and major adverse cardiac events (MACE) during clinical follow-up for 1 year in patients with STEMI and NSTEMI.

Results: There were 447 STEMI patients and 186 NSTEMI patients. Smoking was the most common risk factor in both groups. In the STEMI group, primary percutaneous coronary intervention was performed in 85.0% and thrombolysis was performed in 7.2% of the patients. In the NSTEMI group, an early invasive strategy was chosen in 66.7% of the patients. The in-hospital mortality rate was 3.8% in the STEMI group and 3.2% in the NSTEMI group. The rates of MACE at 6 months and 1 year did not differ significantly between the groups (17.7% vs. 17.3% and 22.8% vs. 20.2%, respectively). Independent predictors of prognosis were diabetes mellitus, smoking, and left ventricular ejection fraction (LVEF) <40% on admission in the NSTEMI group, and serum troponin I in the STEMI group. Troponin I was the only predictor of prognosis in the STEMI group (p=0.047 vs. p=0.139).

Conclusions: Patients with STEMI and NSTEMI had similar clinical outcomes during a 1-year clinical follow-up. Of the predictors of prognosis, troponin I is the only one in STEMI.
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