Does treatment impact health outcomes for patients after acute coronary syndrome?

Int J Environ Res Public Health. 2015 May 29;12(6):6136-47. doi: 10.3390/ijerph120606136.


Background: Mortality rates for acute coronary syndrome (ACS) patients are still very high all over the world. Our study aimed to investigate the impact of ACS treatment on cardiovascular (CV) mortality eight years following ACS.

Methods: A retrospective cohort study with a total of 613 patients was used. The data was collected from databases and medical records. An evidence-based treatment (EBT) algorithm was used based on the ESC guidelines. Logistic regression analysis and standardized odds ratios with 95% confidence interval (CI) were used for the risk assessment, with a p level<0.05 considered as significant.

Results: The median follow-up time in this study was 7.6 years. During follow-up 48.9% of the patients (n=300) died from CV and 207 (69%) for a relevant reason. For monotherapy ACE inhibitors and β-blockers, and for fixed dose combined drugs ACE inhibitors and diuretics, were most frequently used. EBT was provided to 37.8% of patients. The EBT use (HR 0.541, CI 0.394-0.742, p<0.001) during follow-up period was important for reducing CV mortality in ACS patients.

Conclusions: The combined use of EBT significantly improved outcomes. The recurrent myocardial infarction and percutaneous coronary intervention patients were more frequent in EBT and it was beneficial for reducing CV mortality.

Keywords: cardiovascular mortality; evidence-based treatment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Coronary Syndrome / epidemiology*
  • Acute Coronary Syndrome / therapy*
  • Aged
  • Aged, 80 and over
  • Evidence-Based Medicine
  • Female
  • Humans
  • Logistic Models
  • Male
  • Myocardial Infarction / epidemiology
  • Myocardial Infarction / therapy
  • Odds Ratio
  • Retrospective Studies
  • Risk Assessment
  • Treatment Outcome