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- 저자 : 전해정 ( Hae Jung Jeon ) (검색결과 1 건)
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ST분절 비상승 심근경색증 환자에서 증상발생 후 병원 도착 시간이 일년 후 사망률에 미치는 임상적 영향
이선옥 ( Sun Ok Lee ),오상은 ( Sang Eun Oh ),정명호 ( Myung Ho Jeong ),김현국 ( Hyun Kuk KIM ),전해정 ( Hae Jung Jeon ),최영자 ( Young Ja Choi ),김성수 ( Sung Soo Kim ),고점석 ( Jum Suk Ko ),이민구 ( Min Goo Lee ),심두선 ( Soo Sun 대한내과학회 2010 대한내과학회지 Vol.78 No.6
Background/Aims: Symptom-to-door time is associated with the prognosis for ST-segment elevation myocardial infarction. However, this value has not been a concern in patients with non-ST segment elevation myocardial infarction (NSTEMI). The aim of this study was to assess the relationship between symptom-to-door time and clinical outcomes in patients with NSTEMI. Methods: In total, 1,971 patients with NSTEMI (64.8±12.1 years, 23.6% women) were enrolled between Nov. 2005 and Jan. 2008. The patients were divided into two groups according to the time difference between the presentation of symptoms and first medical contact: group I (<12 hours, n=1433) and group II (>12 hours, n=538). One-year mortality rates were compared between the groups. Thrombolysis In Myocardial Infarction (TIMI) and Global Registry of Acute Coronary Events (GRACE) risk scores were calculated in all study patients. Results: The mean age was 64.4±12.2 years in group I and 65.6±12.0 years in group II (p=0.046). No significant differences existed between the two groups, except for the prevalence of hypertension, diabetes mellitus, initial systolic blood pressure, and initial serum creatinine levels. One-year mortality rates decreased significantly in group I patients [hazard ratio (HR)=1.35, 95% CI (confidential interval): 1.03~1.75, p=0.028] based on a multivariate Cox proportional analysis, which was adjusted by GRACE score, baseline characteristic variables, and predictors of a 1-year mortality in a univariate analysis. In intermediate-to high-risk patients (n=1,184, defined as having a TIMI risk score above 3 points), significant differences were observed in mortality rates between the two groups (HR=1.35, 95% CI: 1.02~1.80, p=0.037); the low-risk patients (n=787, HR=1.57, 95% CI: 0.80~3.05, p=0.188), however, showed no such differences. Conclusions: Symptom-to-door time was an independent long-term clinical predictor in patients with NSTEMI, especially in intermediate-to high-risk groups. (Korean J Med 78:717-724, 2010)
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