Copyright © 2004 by the European Society of Cardiology.
Clinical research
Mortality following non-ST elevation acute coronary syndrome: 4 years follow-up of the PRAIS UK Registry (Prospective Registry of Acute Ischaemic Syndromes in the UK)
a Clinical Trials and Evaluation Unit, Royal Brompton and Harefield NHS Trust, Sydney Street, London SW3 6NP, UK
b National Heart and Lung Institute, Imperial College School of Medicine, London, UK
c Hospital Italiano, Buenos Aires, Argentina
d Medical Statistics Unit, London School of Hygiene and Tropical Medicine, UK
e Royal Victoria Hospital, Belfast, UK
f The Royal Infirmary of Edinburgh, Edinburgh, UK
Received February 4, 2004; revised July 31, 2004; accepted August 5, 2004 * Corresponding author. Tel.: +44 (0) 207 351 8827; fax: +44 (0) 207 351 8829 (E-mail: m.flather{at}rbh.nthames.nhs.uk).
Aim To present information on long-term prognosis and risk factors following an admission with non-ST elevation acute coronary syndrome.
Methods A cohort of 653 patients was followed for mortality and causes of death using data from the UK Office of National Statistics (ONS). Cox proportional hazards model was used to identify the prognostic factors.
Results Overall survival at a maximum follow-up of 45 months was 77.8% (95% CI 74.1–81.1%). Seventy-three per cent of the deaths were clearly due to a cardiovascular cause. Age, male gender, heart failure, ST depression or bundle branch block were all associated with higher short- and long-term risk. Taking aspirin or having a revascularization procedure, over the period of six months following initial hospitalisation were both associated with a lower long-term risk.
Conclusion Non-ST elevation acute coronary syndromes carry a high risk of death over a 4-year period. Conventional risk factors can predict both short- and long-term risk. More invasive management and the use of evidence-based therapies appear to be associated with a lower risk.
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