PMID- 37152426
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230509
IS  - 2352-9067 (Print)
IS  - 2352-9067 (Electronic)
IS  - 2352-9067 (Linking)
VI  - 46
DP  - 2023 Jun
TI  - High medium-term incidence of major cardiovascular events in discharged patients 
      with unstable angina.
PG  - 101209
LID - 10.1016/j.ijcha.2023.101209 [doi]
LID - 101209
AB  - The introduction of high-sensitivity troponin (hsTn) assays has reduced the 
      diagnosis of unstable angina (UA) in favor of non-ST elevation myocardial 
      infarction (NSTEMI) in the context of non-ST elevation acute coronary syndrome 
      (NSTEACS). It is unclear whether the detection of these hsTn levels affects the 
      prognosis and therefore whether a different therapeutic approach is warranted. 
      This study aims to determine whether using hsTn results in medium-term prognostic 
      differences in patients with UA and NSTEMI. METHODS: This multicenter, 
      prospective registry study included consecutive patients who underwent hsTn 
      assays and were discharged with a diagnosis of NSTEACS. Patients were followed 
      for two years. Outcomes were the occurrence of major adverse cardiovascular 
      events (MACE: cardiovascular death, non-fatal myocardial infarction, and 
      non-fatal ischemic stroke), major bleeding, and all-cause mortality. RESULTS: 
      Patients with UA and NSTEMI did not show differences in terms of the invasive 
      interventions received, the coronary artery disease diagnosed, the type of 
      revascularization performed, or the proportion presenting MACE (UA 18.1% vs. 
      NSTEMI 18.9%; p = 0.79). However, patients with NSTEMI had higher cardiovascular 
      mortality at two years (UA 4% vs. NSTEMI 9.2%; p = 0.012), as well as, all-cause 
      mortality (UA vs. 7.9% vs. NSTEMI 16.4%; p = 0.002). CONCLUSIONS: Medium-term 
      incidence of MACE was similar in patients with UA and NSTEMI, but cardiovascular 
      and all-cause mortality in NSTEMI patients was over twice that of patients with 
      UA.
CI  - (c) 2023 The Authors.
FAU - Herrero-Brocal, Marta
AU  - Herrero-Brocal M
AD  - Cardiology Department, Dr. Balmis General University Hospital, Alicante Institute 
      for Health and Biomedical Research (ISABIAL), Alicante, Spain.
FAU - Marin, Francisco
AU  - Marin F
AD  - Department of Cardiology, Hospital Clinico Universitario Virgen de la Arrixaca, 
      University of Murcia, Instituto Murciano de Investigacion Biosanitaria 
      (IMIB-Arrixaca), CIBERCV, Murcia, Spain.
FAU - Valverde, Laura
AU  - Valverde L
AD  - Cardiology Department, Dr. Balmis General University Hospital, Alicante Institute 
      for Health and Biomedical Research (ISABIAL), Alicante, Spain.
FAU - Garcia-Barrios, Ana M
AU  - Garcia-Barrios AM
AD  - Cardiology Department, Dr. Balmis General University Hospital, Alicante Institute 
      for Health and Biomedical Research (ISABIAL), Alicante, Spain.
FAU - Fuertes, Laura
AU  - Fuertes L
AD  - Cardiology Department, Dr. Balmis General University Hospital, Alicante Institute 
      for Health and Biomedical Research (ISABIAL), Alicante, Spain.
FAU - Cambra, Cristina
AU  - Cambra C
AD  - Cardiology Department, Torrevieja University Hospital, Alicante, Spain.
FAU - Torres-Mezcua, Fernando
AU  - Torres-Mezcua F
AD  - Cardiology Department, Dr. Balmis General University Hospital, Alicante Institute 
      for Health and Biomedical Research (ISABIAL), Alicante, Spain.
FAU - Hortelano, Ignacio
AU  - Hortelano I
AD  - Cardiology Department, Hospital Marina Baja de Villajoyosa, Alicante, Spain.
FAU - Villamia, Beatriz
AU  - Villamia B
AD  - Cardiology Department, Torrevieja University Hospital, Alicante, Spain.
FAU - Esteve-Pastor, Maria Asuncion
AU  - Esteve-Pastor MA
AD  - Department of Cardiology, Hospital Clinico Universitario Virgen de la Arrixaca, 
      University of Murcia, Instituto Murciano de Investigacion Biosanitaria 
      (IMIB-Arrixaca), CIBERCV, Murcia, Spain.
FAU - Orenes-Pinero, Esteban
AU  - Orenes-Pinero E
AD  - Department of Cardiology, Hospital Clinico Universitario Virgen de la Arrixaca, 
      University of Murcia, Instituto Murciano de Investigacion Biosanitaria 
      (IMIB-Arrixaca), CIBERCV, Murcia, Spain.
FAU - Martinez, Juan Gabriel Martinez
AU  - Martinez JGM
AD  - Cardiology Department, Dr. Balmis General University Hospital, Alicante Institute 
      for Health and Biomedical Research (ISABIAL), Alicante, Spain.
FAU - Rivera-Caravaca, Jose Miguel
AU  - Rivera-Caravaca JM
AD  - Department of Cardiology, Hospital Clinico Universitario Virgen de la Arrixaca, 
      University of Murcia, Instituto Murciano de Investigacion Biosanitaria 
      (IMIB-Arrixaca), CIBERCV, Murcia, Spain.
FAU - Ruiz-Nodar, Juan M
AU  - Ruiz-Nodar JM
AD  - Cardiology Department, Dr. Balmis General University Hospital, Alicante Institute 
      for Health and Biomedical Research (ISABIAL), Alicante, Spain.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20230426
PL  - Ireland
TA  - Int J Cardiol Heart Vasc
JT  - International journal of cardiology. Heart & vasculature
JID - 101649525
PMC - PMC10160493
OTO - NOTNLM
OT  - High-sensitivity troponin
OT  - Major adverse cardiovascular events
OT  - Non-ST elevation myocardial infarction
OT  - Prognosis
OT  - Unstable angina
COIS- The authors declare the following financial interests/personal relationships 
      which may be considered as potential competing interests: 'This study has been 
      partially supported by a Research Grant from the Spanish Society of Cardiology 
      (SEC).'
EDAT- 2023/05/08 06:41
MHDA- 2023/05/08 06:42
PMCR- 2023/04/26
CRDT- 2023/05/08 04:03
PHST- 2023/02/22 00:00 [received]
PHST- 2023/04/10 00:00 [revised]
PHST- 2023/04/12 00:00 [accepted]
PHST- 2023/05/08 06:42 [medline]
PHST- 2023/05/08 06:41 [pubmed]
PHST- 2023/05/08 04:03 [entrez]
PHST- 2023/04/26 00:00 [pmc-release]
AID - S2352-9067(23)00040-4 [pii]
AID - 101209 [pii]
AID - 10.1016/j.ijcha.2023.101209 [doi]
PST - epublish
SO  - Int J Cardiol Heart Vasc. 2023 Apr 26;46:101209. doi: 
      10.1016/j.ijcha.2023.101209. eCollection 2023 Jun.