Unstable angina and non-ST-segment elevation myocardial infarction: analysis of consecutive series of patients and later follow-up

Introduction

According to world statistics, arteriosclerotic coronary disease has been growing worldwide, receiving special attention in ICUs.

Materials and methods

One hundred and ninety-three patients with acute coronary syndromes (ACS) admitted to the ICU of Santa Lucia Hospital from October 2003 to October 2004 were analyzed prospectively. A total 62.2% developed unstable angina or non-ST-segment elevation myocardial infarction (NSTEMI). The data collection was made using interviews, chart reviews and other examinations.

Results

One hundred and twenty patients had NSTEMI or unstable angina. The mean age was 66.3 years and 80 were men. The most common risk factor was hypertension (90/75.0%). Seventy-one (59.2%) patients showed previous history of ACS; 29 out of this group had previous myocardial infarction, and 28 patients had been submitted to coronary artery bypass graft (CABG) previously. Seventy-seven (64.2%) patients were submitted to coronary angiography; 23 of them were submitted to angioplasty with stent implantation and 21 to CABG. The mean ICU stay was 3.6 days. The mortality rate was 10%. The follow-up was made by telephone contact with 94.1% of the patients more than 6 months from the event. A total 33.3% of them were readmitted for cardiac causes, and late mortality was 5.9% of followed-up patients.

Conclusion

The follow-up reached a high percentage of the population studied and showed a late mortality compatible with the medical literature.