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Effect of delayed hospitalization on 3-year clinical outcomes according to renal function in patients with non-ST-segment elevation myocardial infarction.
- Source :
-
Cardiology journal [Cardiol J] 2024; Vol. 31 (2), pp. 271-284. Date of Electronic Publication: 2023 May 29. - Publication Year :
- 2024
-
Abstract
- Background: We evaluated the effect of delayed hospitalization (symptom-to-door time [STD] ≥ 24 h) on 3-year clinical outcomes according to renal function in patients with non-ST-segment elevation myocardial infarction (NSTEMI) undergoing new-generation drug-eluting stent (DES) implantation.<br />Methods: A total of 4513 patients with NSTEMI were classified into chronic kidney disease (CKD) (estimated glomerular filtration rate [eGFR] < 60 mL/min/1.73 m², n = 1118) and non-CKD (eGFR ≥ 60 mL/min/1.73 m², n = 3395) groups. They were further sub-classified into groups with (STD ≥ 24 h) and without (STD < 24 h) delayed hospitalization. The primary outcome was the occurrence of major adverse cardiac and cerebrovascular events (MACCE), defined as all-cause death, recurrent myocardial infarction, any repeat coronary revascularization, and stroke. The secondary outcome was stent thrombosis (ST).<br />Results: After multivariable-adjusted and propensity score analyses, the primary and secondary clinical outcomes were similar in patients with or without delayed hospitalization in both CKD and non-CKD groups. However, in both the STD < 24 h and STD ≥ 24 h groups, MACCE (p < 0.001 and p < 0.006, respectively) and mortality rates were significantly higher in the CKD group than in the non-CKD group. However, ST rates were similar between the CKD and non-CKD groups and between the STD < 24 h and STD ≥ 24 h groups.<br />Conclusions: Chronic kidney disease appears to be a much more important determinant of MACCE and mortality rates than STD in patients with NSTEMI.
- Subjects :
- Humans
Male
Female
Aged
Time Factors
Risk Factors
Treatment Outcome
Middle Aged
Retrospective Studies
Time-to-Treatment
Kidney physiopathology
Japan epidemiology
Risk Assessment
Follow-Up Studies
Registries
Propensity Score
Non-ST Elevated Myocardial Infarction mortality
Non-ST Elevated Myocardial Infarction therapy
Non-ST Elevated Myocardial Infarction physiopathology
Non-ST Elevated Myocardial Infarction diagnosis
Glomerular Filtration Rate
Renal Insufficiency, Chronic physiopathology
Renal Insufficiency, Chronic complications
Renal Insufficiency, Chronic therapy
Renal Insufficiency, Chronic diagnosis
Drug-Eluting Stents
Percutaneous Coronary Intervention
Hospitalization
Subjects
Details
- Language :
- English
- ISSN :
- 1898-018X
- Volume :
- 31
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Cardiology journal
- Publication Type :
- Academic Journal
- Accession number :
- 37246457
- Full Text :
- https://doi.org/10.5603/CJ.a2023.0036