Cardiac events and 5-year survival after acute coronary syndromes

Remigijus Žaliūnas¹, Marija Rūta Babarskienė^{1, 2}, Dalia Lukšienė², Jonė Venclovienė^{2, 4}, Birutė Šlapikienė², Irena Milvidaitė^{1, 2}, Eugenija Audronė Statkevičienė^{1, 2}, Vita Linonienė³

¹Department of Cardiology, ²Institute of Cardiology, Kaunas University of Medicine, ³Clinic of Cardiology, Kaunas University of Medicine Hospital, ⁴Vytautas Magnus University, Lithuania

Key words: acute coronary syndromes, long-term survival.

Summary. Objective. To evaluate the incidence of cardiac events and survival in patients with first acute coronary syndromes during 5-year period.

Methods and results. Data on 732 patients admitted with first acute coronary syndrome were collected in a database. During hospitalization period 45.4% of the patients received reperfusion therapy. During follow-up period (4.49±2.1 years) 215 (29.4%) patients had cardiac events: 15.3% – myocardial revascularization, 8.1% – repeated myocardial infarction, 11.5% – cardiovascular deaths. The highest (5%) mortality rate was during first year, whereas during the following four years – 1.5% annually. Kaplan–Meier analysis for survival free of cardiovascular death revealed that mortality rates were higher among patients who were ≥65 years old (long-rank test, p=0.02); had heart failure at admission (p=0.003), left ventricular ejection fraction <40% (p=0.04), significance diastolic dysfunction (p=0.035), III–IV° mitral regurgitation (p=0.00006); did not received reperfusion therapy (p=0.007).

Conclusion. The analysis of this long-term follow-up data shows that the patients with acute coronary syndromes carry a high risk of death and need better treatment strategies to reduce risk.

Correspondence to M. R. Babarskienė, Institute of Cardiology, Kaunas University of Medicine, Sukilėlių 17, 50161 Kaunas, Lithuania. E-mail: ruta@kmu.lt

Received 28 April 2005, accepted 22 August 2005