Má výber úvodnej liečby u pacientov s akútnym koronárnym syndrómom bez elevácií segmentov ST vplyv na dlhodobý priebeh?

Methods: Prospective analysis of patients with non ST elevation acute coronary syndromes. Following parameters were evaluated during a one-year follow-up: mortality rate, reinfarction, rehospitalization for acute coronary syndromes, repeated percutaneous coronary intervention and left ventricular ejection fraction. These parameters were assessed in groups of patients with early coronary intervention or surgical revascularization or with early conservative approach, and among patients who refused invasive diagnostic procedure. Results: In the whole group of 183 non ST elevation acute coronary syndrome patients there were 109 men, aged 35 - 84 (mean 55.9) years and 74 women, aged 44 - 86 (mean 66.5) years. Coronary intervention was performed in 84 patients (group A), surgery revascularization in 48 patients (group B) and conservative treatment was chosen in 39 patients (group C). Early coronary angiography was refused in a group of 12 patients (D). Mortality rate during the one-year follow-up was: in group A: 4.8%, B: 4.2.%, C: 10.3% and D: 16.7%, combined end point rehospitalization/reinfarction/recoronary intervention was observed in groups A: 13.1%, B: 10.4, C: 15.4% and D: 41.7, left ventricular ejection fraction ≥ 50% was found in groups A: 84.5%, B: 64.6, C: 56.4% and D: 33.3%. Conclusion: Invasive strategy with early indicated coronary angiography and revascularization, when feasible, is associated in patients with non ST elevation acute coronary syndromes with favorable clinical outcomes during a one-year follow-up.