Scandinavian cardiovascular journal : SCJ
-
Scand. Cardiovasc. J. · Jun 2020
Comparative Study Observational StudyThree-year outcomes related to coronary stenting; a registry-based real-life population study.
Objectives. Developments in medication and coronary interventions have improved coronary artery disease (CAD) treatment. We studied long-term outcomes in an observational, real-life population of CAD patients undergoing percutaneous coronary intervention (PCI) depending on the presentation and the stent type used. ⋯ Irrespective of comorbidities, NSTEMI was not associated with worse outcome than stable CAD. DES-2 was associated with lower rates of MACE than BMS without affecting mortality rate. Patients succeeded better in smoking cessation than reaching recommended cholesterol levels.
-
Scand. Cardiovasc. J. · Jun 2020
Observational StudyDiagnostic accuracy of troponin T measured ≥6h after symptom onset for ruling out myocardial infarction.
Objectives: Guidelines recommend a single high-sensitivity cardiac troponin T (hs-cTnT) ≤14 ng/L measured ≥6 h after chest pain onset combined with a GRACE score <140 and the patient being pain-free for ruling out myocardial infarction (MI). There is however little data on the performance of this strategy. We therefore aimed to evaluate the diagnostic accuracy of a hs-cTnT ≤14 ng/L measured ≥6 h after chest pain onset when combined with GRACE score or other clinical risk stratification tools. ⋯ An isolated hs-cTnT ≤14 ng/L measured ≥6 h after chest pain onset and the combination with GRACE score both had a NPV <98% for ruling out 30-day MACE. Conclusion: A single hs-cTnT ≤14 ng/L obtained ≥6 h from chest pain onset, with and without GRACE score, reliably ruled out MI but did not perform well for ruling out 30-day MACE. These results question current guideline recommendations, and indicate that HEART, EDACS, TIMI, or ECG + patient history strategies should be the preferred risk stratification tools.
-
Scand. Cardiovasc. J. · Jun 2020
Comparative StudyThe association between charlson comorbidity index and mortality in acute coronary syndrome - the MADDEC study.
Objectives. Acute coronary syndrome (ACS) is associated with high mortality. Charlson comorbidity index (CCI) was designed over 30 years ago to measure the impact of pre-existing comorbidities on long-term survival of the patient. ⋯ Adding components of CCI did not significantly improve risk prediction over GRACE-score. Conclusions. In conclusion, CCI or its individual components measuring the impact of comorbidities on overall mortality does not provide any significant value compared to GRACE-score during up to 2 years of follow-up.