Predictors of Long-term Outcome in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention: A single center registry (THCR)

Abstract

Background: This study sought to access differences in long-term (9 months) outcomes between Acute Coronary Syndrome (ACS) patients who undergo early intervention compared to Percutaneous Coronary Intervention (PCI) in stable and refractory conditions.

Methods: Data originated from Tehran Heart Center Registry- interventional cardiology (THCR-IC) and consisted of 1267 patients divided into two categories; 227 patients had features corresponding to acute coronary syndromes (17.9%) and 1040 patients suffered from stable angina (82.1%). They were admitted between April 3, 2003 and April 25, 2004.

Results: The clinical success rate of PCI was higher in ACS (97% vs. 94%; P=0.037), while In-hospital complications were similar in both groups. During the follow-up period, clinical restenosis was not significantly different and the overall number of re-interventions caused by restenosis or progression was not more frequent in ACS patients. Also, 1.3% of ACS and 0.4% of SA patients died, but the difference was not statistically significant (P=0.16). Finally, Major Adverse Cardiac Events (MACE) showed no significant difference (5.2% vs. 3.9%; P=0.42). Multivariate analysis showed that female sex (OR=25.6; P=0.003) and previous history of PCI (OR=8.4; P=0.016) were the only strong independent risk factors for major adverse cardiac events. Analyzing ACS patient outcomes using Mantel-Hanzel analysis showed that the female sex was the only factor which strongly increased the incidence of MACE.

Conclusion: Both ACS and SA patients who underwent coronary intervention had similar in-hospital and composite major adverse cardiac events, nevertheless female gender must be considered as an independent risk factor for major adverse cardiac events especially in patients with acute coronary syndrome who undergo PCI.