PMID- 16620349
OWN - NLM
STAT- MEDLINE
DCOM- 20061204
LR  - 20070214
IS  - 1368-5031 (Print)
IS  - 1368-5031 (Linking)
VI  - 60
IP  - 4
DP  - 2006 Apr
TI  - Management and outcomes of acute coronary syndrome with minimal myocardial 
      necrosis: analysis of a large prospective registry from a non-interventional 
      centre.
PG  - 383-90
AB  - The aim of this study was to assess the clinical risk of minimal myonecrosis 
      below the cut-off for acute myocardial infarction (MI) in comparison with other 
      grades of acute coronary syndrome (ACS). One-thousand four hundred and sixty 
      seven consecutive patients with ACS admitted between May 2001 and April 2002 were 
      studied in a non-interventional centre. Patients were divided into unstable 
      angina (UA) (cTnT < 0.01 microg/l), non-ST elevation ACS with minimal myonecrosis 
      (0.01 <or= cTnT < 0.1 microg/l), non-ST elevation MI (NSTEMI) (cTnT >or= 0.1 
      microg/L) and ST elevation myocardial infarction (STEMI). UA (n = 638) was 
      associated with the fewest events at 6 months (2% cardiac death or MI). Patients 
      with any myonecrosis (n = 829) had worse outcomes (6-month cardiac death or MI 
      18.3-23.3%). Compared with ACS patients with minimal myonecrosis, UA patients 
      were at significantly lower risk (OR 0.21, 95% CI 0.12-0.45, p < 0.001), NSTEMI 
      patients were at similar risk (OR 1.45, 95% CI 0.89-2.35, p = 0.13), and STEMI 
      patients were at higher risk (OR 2.12 95% CI 1.26-3.85, p = 0.008) in adjusted 
      analyses. Nearly 85% of cardiac deaths occurred within 6 months. The risk of 
      adverse events was higher among patients managed by non-cardiologists (OR 1.66, 
      95% CI 1-2.75, p = 0.049). Patients with non-ST elevation ACS and minimal 
      myonecrosis are a high-risk group more comparable with NSTEMI and clearly 
      distinguishable from patients with UA.
FAU - Ray, K K
AU  - Ray KK
AD  - Cardiology Department, Doncaster Royal Infirmary, Doncaster, UK. 
      kkray@partners.org
FAU - Sheridan, P J
AU  - Sheridan PJ
FAU - Bolton, J
AU  - Bolton J
FAU - Clayton, T C
AU  - Clayton TC
FAU - Veitch, A
AU  - Veitch A
FAU - Manivarmane, R
AU  - Manivarmane R
FAU - Al Rifai, A
AU  - Al Rifai A
FAU - Payne, G
AU  - Payne G
FAU - Baig, W
AU  - Baig W
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - India
TA  - Int J Clin Pract
JT  - International journal of clinical practice
JID - 9712381
SB  - IM
MH  - Aged
MH  - Angina, Unstable/*drug therapy/pathology
MH  - Coronary Angiography
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*drug therapy/pathology
MH  - Myocardium/*pathology
MH  - Necrosis
MH  - Prognosis
MH  - Prospective Studies
MH  - Risk Factors
EDAT- 2006/04/20 09:00
MHDA- 2006/12/09 09:00
CRDT- 2006/04/20 09:00
PHST- 2006/04/20 09:00 [pubmed]
PHST- 2006/12/09 09:00 [medline]
PHST- 2006/04/20 09:00 [entrez]
AID - IJCP816 [pii]
AID - 10.1111/j.1368-5031.2006.00816.x [doi]
PST - ppublish
SO  - Int J Clin Pract. 2006 Apr;60(4):383-90. doi: 10.1111/j.1368-5031.2006.00816.x.