Kozłowska-Karaca Izabela, Desperak Piotr, Gąsior Mariusz, Trzeciak Przemysław
Department of Hematology and Cancer Prevention, Municipal Hospital in Chorzów, Poland.
Cardiology Department, Voivodeship Specialist Hospital in Rybnik, Poland.
Cardiol J. 2024;31(6):823-832. doi: 10.5603/cj.100464. Epub 2024 Oct 24.
Changes in the management of patients with chronic coronary syndromes (CCS) require continuous monitoring of results of treatment in daily clinical practice. The present study contains a comparison of the clinical characteristics, management, and in-hospital and five-year outcomes of patients with CCS enrolled on the Prospective REgistry of Stable AnGina management and trEatment (PRESAGE).
A group of 3475 patients with CCS were selected who underwent coronary angiography and were divided into two groups who were treated in the years 2006-2007 (1300 [37.4%]) - group I, and during 2015-2016 (2175 [62.6%] - group II). The composite endpoints involved death, non-fatal myocardial infarction (MI), and acute coronary syndrome-driven revascularization.
Comparing patients from group I to those from group II, group I were younger; 61.8 (54.9-68.5) vs. 66.1 (59.7-72.7) years respectively, with a higher incidence of previous MI and percutaneous intervention. Patients from the group II had a higher incidence of hypertension, diabetes, obesity, atrial fibrillation, New York Heart Association class III or more. The incidence of the composite endpoints did not vary significantly between the two groups during the entire period after the index hospitalization, but patients from the group I had a lower mortality rate both within three and five years after discharge (8.5% vs. 10.7, p = 0.03 and 13.2% vs. 17.9%, p < 0.001, respectively).
Patients treated during 2006-2007 and 2015-2016 differed in age, clinical characteristics, and comorbidities. The composite endpoint incidence was similar in both groups,butlong-term mortality rates werehigherin the 2015-2016 cohort.
慢性冠状动脉综合征(CCS)患者管理方式的改变需要在日常临床实践中持续监测治疗结果。本研究比较了纳入稳定型心绞痛管理与治疗前瞻性注册研究(PRESAGE)的CCS患者的临床特征、管理方式以及住院期间和五年的结局。
选取3475例接受冠状动脉造影的CCS患者,分为两组,2006 - 2007年治疗的患者为一组(1300例[37.4%]),2015 - 2016年治疗的患者为二组(2175例[62.6%])。复合终点包括死亡、非致命性心肌梗死(MI)和急性冠状动脉综合征驱动的血运重建。
将一组患者与二组患者进行比较,一组患者更年轻,年龄分别为61.8(54.9 - 68.5)岁和66.1(59.7 - 72.7)岁,既往MI和经皮介入治疗的发生率更高。二组患者高血压、糖尿病、肥胖、心房颤动、纽约心脏协会III级或更高级别的发生率更高。在首次住院后的整个期间,两组复合终点的发生率无显著差异,但一组患者出院后三年和五年内的死亡率均较低(分别为8.5%对10.7%,p = 0.03;13.2%对17.9%,p < 0.001)。
2006 - 2007年和2015 - 2016年治疗的患者在年龄、临床特征和合并症方面存在差异。两组复合终点发生率相似,但2015 - 2016年队列的长期死亡率更高。