EARLY PREDICTORS OF 30-DAY MORTALITY INNON-ST-ELEVATION ACUTE CORONARY SYNDROME PATIENTS

Abstract

BACKGROUND The incidence of non-ST-elevation acute coronary syndrome (ACS), including unstableangina pectoris and non-ST-elevation myocardial infarction (MI), is increasing incomparison to ST-elevation ACS. Our aim was to evaluate predictive role of admissionvariables for 30-day mortality in non-ST-elevation ACS patients.Patients and We retrospectively analysed the data of 415 patients, admitted to University Clinicalmethods Center Maribor in 2006 due to non-ST-elevation ACS. Inclusion criteria were rest chestpain, ECG changes (ST-segment depression ? 0.1 mV, and/or negative T wave ? 0.1 mVand/or pathologic Q and/or non-specific ECG) and/or increased troponin T levels. Predictors of 30-day mortality were analysed by univariate and multivariate logistic regression. RESULTS 30-day mortality was 4.3 %. Between nonsurvivors and survivors there were significantdifferences in mean age, the incidence of arterial hypertension, positive family history ofcoronary artery disease, in mean admission systolic and diastolic blood pressure, pulse,mean admission troponin T, leukocyte count, CRP, creatinine and the incidence of admission heart failure. Multivariate logistic regression proved that most significant independent early predictor of 30-day mortality was admission heart failure (OR 41.21, 95 %CI 3.50 to 484.66, p = 0.003), followed by admission serum creatinine (OR 0.989, 95 %CI 0.981 to 0.997, p = 0.008) and troponin T (OR 0.263, 95 % CI 0.080 to 0.861).Conclusion Most significant independent predictor of 30-day mortality of patients with non-ST-elevation ACS, being 4.5 %, was heart failure on admission