Risk factors of death or re-hospitalization in acute coronary syndrome patients before and after earlier heart revascularization
Walkowicz, W.; Gasior, Z.; Mizia-Stec, K.; Dabek, J.óz.
Polski Merkuriusz Lekarski Organ Polskiego Towarzystwa Lekarskiego 30(176): 97-101
2011
ISSN/ISBN: 1426-9686 PMID: 21544978 Document Number: 654372
Cardiovascular diseases including coronary artery disease and its complications--acute coronary syndromes (ACS) are the leading causes of mortality in developed countries. With the growing number of percutaneous revascularization procedures (PCI) patients with at least one prior revascularization procedure constitute a growing population. The aim of the study was to define the predictors of death and rehospitalization of patients treated for ACS before and after earlier heart revascularization. The study group consisted of 325 patients admitted with the ACS symptoms, 147 patients with prior PCI, 28 patients with former surgical revascularization and 150 patients with no prior coronary artery revascularization procedure. Case-history acquisition, physical examination, ECG, ultrasound echocardiography, coronary angiography and angioplasty of the ACS related vessel as well as the laboratory assessment of morphology, creatinine, sodium, potassium, glucose, troponine I, creatine kinase and its MB isoenzyme serum levels were performed in all cases. The study revealed that cardiogenic shock at the baseline, non-successful PCI procedure, impaired < 45% left ventricle ejection fraction were the independent predictors for death or re-hospitalization due to ACS onset. Even though ACS patients with prior revascularization history have worse echocardiographic parameters which have determined prognostic value, compared with patients with no prior revascularization the prognosis for the 6-month follow-up in both groups remains comparable.