Division of Cardiology, Department of Internal Medicine, College of Medicine, Pusan National University, 10 Ami-dong 1-ga Seo-gu, Busan, Korea.
Cardiol J. 2011;18(4):421-9.
Patients with acute coronary syndrome without ST-segment elevation (ACS- -NSTE) are at risk for adverse cardiac events. Based on data in the Korean Acute Myocardial Infarction Registry (KAMIR), we analyzed the prognosis according to the timing of percutaneous coronary intervention (PCI) in patients with NSTEMI in Korea.
2,455 patients with NSTEMI in KAMIR were classified according to the time interval from the onset of cardiac symptoms to PCI. Patients in Group I underwent PCI within 24 hours of the onset of symptoms; in Group II between 24 and 48 hours; and in Group III after 48 hours. Major adverse cardiac events (MACEs) are defined as cardiac death, non-cardiac death, myocardial infarction, revascularization and coronary-artery bypass graft surgery. The MACEs were compared between groups. Of the 2,455 patients, 743 (30.2%) were assigned to Group I, 583 (23.7%) to Group II, and 1,129 (45.9%) to Group III. The total incidence of MACEs was higher in Group I than Group III, and similar between Groups I and II (Group I: 15.1%, Group II: 14.4%, Group III: 11.6%, p = 0.053). The incidence of MACEs in the intermediate TIMI risk score group had decreased as the intervention time was delayed.
The prognosis according to the timing of PCI in patients with NSTEMI was similar based on the data in KAMIR. TIMI risk score was related to a high incidence of MACEs.
无 ST 段抬高的急性冠状动脉综合征（ACS-NSTE）患者存在不良心脏事件风险。基于韩国急性心肌梗死注册研究（KAMIR）的数据，我们分析了韩国 NSTEMI 患者经皮冠状动脉介入治疗（PCI）时机与预后的关系。
KAMIR 中 2455 例 NSTEMI 患者根据从心脏症状发作到 PCI 的时间间隔进行分类。第 I 组患者在症状发作后 24 小时内行 PCI；第 II 组在 24 至 48 小时内行 PCI；第 III 组在 48 小时后行 PCI。主要不良心脏事件（MACE）定义为心脏性死亡、非心脏性死亡、心肌梗死、血运重建和冠状动脉旁路移植术。比较各组之间的 MACE。2455 例患者中，743 例（30.2%）分入第 I 组，583 例（23.7%）分入第 II 组，1129 例（45.9%）分入第 III 组。第 I 组的 MACE 总发生率高于第 III 组，与第 II 组无差异（第 I 组：15.1%，第 II 组：14.4%，第 III 组：11.6%，p=0.053）。随着干预时间的延迟，中间 TIMI 风险评分组的 MACE 发生率下降。
基于 KAMIR 数据，NSTEMI 患者 PCI 时机与预后相似。TIMI 风险评分与 MACE 发生率高相关。
