PMID- 11773913
OWN - NLM
STAT- MEDLINE
DCOM- 20020125
LR  - 20190626
IS  - 1097-6744 (Electronic)
IS  - 0002-8703 (Linking)
VI  - 143
IP  - 1
DP  - 2002 Jan
TI  - Mode and timing of treatment failure (recurrent ischemic events) after hospital 
      admission for non-ST segment elevation acute coronary syndromes.
PG  - 63-9
AB  - BACKGROUND: Clarification of the specific clinical course of non-ST-segment 
      elevation acute coronary syndromes (NSTEMI ACS), including recurrent ischemic 
      events and need for coronary revascularization, is important given the increasing 
      economic pressure to shorten the length of hospitalization and therefore the 
      duration of acute therapy. To examine the mode and timing of subsequent cardiac 
      events, we analyzed pooled data from the ESSENCE and TIMI 11B studies of 
      antithrombotic therapy in NSTEMI ACS. METHODS: The daily event rates (with 
      confidence intervals) during the first 43 days and the monthly average event 
      rates during the first year were tabulated for 7081 patients. RESULTS: The median 
      antithrombotic treatment duration was 3.2 days, whereas the highest absolute 
      frequency of recurrent angina prompting urgent revascularization, myocardial 
      infarction, or death after hospital admission occurred on day 2, day 3, and day 
      8, respectively. Coronary revascularization was performed in 32% of patients, 
      with the greatest number occurring on day 4. Only 12% of the end point events 
      were adjudicated as being periprocedural. The median length of hospital stay was 
      7 days. CONCLUSIONS: Despite aggressive antithrombotic therapy, a significant 
      proportion of patients with NSTEMI ACS have recurrent ischemia precipitating 
      urgent revascularization or infarction within the first few days, whereas the 
      highest risk of death occurs later, after the first week.
FAU - Cohen, Marc
AU  - Cohen M
AD  - Division of Cardiology, MCP-Hahnemann University School of Medicine, 
      Philadelphia, Pennsylvania, USA. marc.cohen@tenethealth.com
FAU - Antman, Elliott M
AU  - Antman EM
FAU - Murphy, Sabina A
AU  - Murphy SA
FAU - Radley, David
AU  - Radley D
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
SB  - IM
MH  - Angina Pectoris/etiology
MH  - Cause of Death
MH  - Confidence Intervals
MH  - Double-Blind Method
MH  - Female
MH  - Hospitalization
MH  - Humans
MH  - Length of Stay
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/etiology
MH  - Myocardial Ischemia/*drug therapy/mortality
MH  - Myocardial Revascularization/mortality
MH  - Odds Ratio
MH  - Prospective Studies
MH  - Recurrence
MH  - Thrombolytic Therapy
MH  - Treatment Failure
EDAT- 2002/01/05 10:00
MHDA- 2002/01/26 10:01
CRDT- 2002/01/05 10:00
PHST- 2002/01/05 10:00 [pubmed]
PHST- 2002/01/26 10:01 [medline]
PHST- 2002/01/05 10:00 [entrez]
AID - S0002870302841084 [pii]
AID - 10.1067/mhj.2002.119767 [doi]
PST - ppublish
SO  - Am Heart J. 2002 Jan;143(1):63-9. doi: 10.1067/mhj.2002.119767.