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Use of the invasive management strategy for patients with non-Q-wave myocardial infarction: an observational database report from the Worcester Heart Attack Study.

Abstract：

BACKGROUND:Recent randomized clinical trials have suggested a benefit of an invasive management strategy in patients with acute coronary syndromes. However, the broader use and impact of the invasive management approach has not been established for patients with acute coronary syndromes beyond the relatively narrow patient populations studied in randomized, clinical trials. METHODS:Residents of the Worcester, Mass, area who were hospitalized with non-Q-wave acute myocardial infarction (AMI) at all area hospitals in 5 annual periods between 1990 and 1997 comprised the sample of interest (n = 2436). We examined the extent of use of an invasive versus a conservative strategy for hospital management, occurrence of clinical complications, and hospital mortality in patients with non-Q-wave AMI. RESULTS:An invasive approach to hospital management was used in only 30% of patients with non-Q-wave AMI, although there was an increase over time in the use of an invasive treatment strategy (18% in 1990 vs 33% in 1997). Factors associated with use of the invasive strategy were younger age, male sex, development of cardiogenic shock, as well as adjunctive medical treatment. Overall hospital mortality was high at 12%. Use of the invasive approach, aspirin, nitrates and beta-blockers were associated in logistic regression modeling with significant improvements in survival. CONCLUSIONS:An invasive approach to hospital management of non-Q-wave AMI was used infrequently in this population-based cohort during the 1990s.

journal_name

Am Heart J

journal_title

American heart journal

authors

Dauerman HL,Yarzebski J,Gore JM,Lessard D,Goldberg RJ

doi

10.1067/mhj.2002.122517

subject

Has Abstract

pub_date

2002-06-01 00:00:00

pages

1033-9

issue

6

eissn

0002-8703

issn

1097-6744

pii

S0002870302000194

journal_volume

143

pub_type

杂志文章,多中心研究

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