Kern Adam, Stompór Tomasz, Bojko Krystian, Sienkiewicz Ewa, Pawlak Sebastian, Pawlak Krystyna, Pawlak Dariusz, Poskrobko Grzegorz, Andrasz Ewa, Gromadziński Leszek, Jalali Rakesh, Onichimowski Dariusz, Piwko Grażyna, Zalewski Artur, Bil Jacek
Department of Cardiology and Internal Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-727 Olsztyn, Poland.
Department of Cardiology, Regional Specialist Hospital in Olsztyn, 10-045 Olsztyn, Poland.
Biomedicines. 2024 Nov 23;12(12):2672. doi: 10.3390/biomedicines12122672.
This study aimed to characterize acute coronary syndrome (ACS) patients undergoing invasive diagnostics and to evaluate prognostic factors for all-cause mortality over a 10-year follow-up period.
The KORONEF study was a prospective, observational, single-center study that enrolled 492 patients, of whom 467 had confirmed coronary artery disease (CAD). Baseline demographic, clinical, laboratory, and procedural data were analyzed, focusing on the differences between ACS and chronic coronary syndrome (CCS) patients.
Males made up the majority of both the CCS and ACS groups (62.2% vs. 63.6%, = 0.773), with no statistically significant difference in patient age between the CCS and ACS subpopulations (64.9 ± 9.5 vs. 63.7 ± 10.3, = 0.106). The 10-year all-cause mortality was 29.8%, with no statistically significant difference between ACS and CCS patients. However, statistically significantly more patients with CCS underwent CABG in the follow-up than ACS patients (9.9% vs. 4.6%, = 0.042). In a multivariable analysis, in the ACS subgroup, statistically significant predictors of all-cause mortality at 10 years included being between 75 and 90 years old (HR 4.99), not having had a previous stroke (HR 0.27), the absence of cardiac arrest (HR 0.20), and a left ventricular ejection fraction > 60% (HR 0.23).
The long-term outcomes of the ACS patients highlight age and left ventricular function as significant prognostic factors, underscoring the importance of these parameters in risk stratification.
本研究旨在对接受侵入性诊断的急性冠状动脉综合征（ACS）患者进行特征描述，并评估10年随访期内全因死亡率的预后因素。
KORONEF研究是一项前瞻性、观察性、单中心研究，纳入了492例患者，其中467例确诊为冠状动脉疾病（CAD）。分析了基线人口统计学、临床、实验室和手术数据，重点关注ACS患者与慢性冠状动脉综合征（CCS）患者之间的差异。
CCS组和ACS组中男性均占大多数（62.2%对63.6%，P = 0.773），CCS亚组和ACS亚组患者年龄无统计学显著差异（64.9±9.5对63.7±10.3，P = 0.106）。10年全因死亡率为29.8%，ACS患者和CCS患者之间无统计学显著差异。然而，随访中接受冠状动脉旁路移植术（CABG）的CCS患者在统计学上显著多于ACS患者（9.9%对4.6%，P = 0.042）。在多变量分析中，在ACS亚组中，10年全因死亡率的统计学显著预测因素包括年龄在75至90岁之间（风险比[HR]4.99）、既往无中风（HR 0.27）、无心脏骤停（HR 0.20）以及左心室射血分数>60%（HR 0.23）。
ACS患者的长期预后突出了年龄和左心室功能作为重要的预后因素，强调了这些参数在风险分层中的重要性。
