Prognostication of long-term outcomes for patients with ischemic heart disease

Abstract

Cardiovascular disease, including coronary heart disease (CHD), is the leading cause of death among elderly adults across many European countries. In 2005, the Clinic of Cardiology, Hospital of Lithuanian University of Health Sciences (former Kaunas University of Medicine), started to gather the clinical data of patients with acute and chronic coronary syndromes according to the standards set by the Cardiology Audit and Registration Data Standards Project. The aim of our study was to evaluate one-year mortality after inpatient treatment for acute and chronic coronary syndromes in different risk groups. Material and methods: A total of 3268 patients who were treated for coronary heart disease -acute myocardial infarction, unstable angina, stable angina - at the Clinic of Cardiology, Hospital of Lithuanian University of Health Sciences (former Kaunas University of Medicine) in 2005 were randomly selected. Clinical data of the patients were collected by means of a standardized questionnaire. After one year, 1908 patients were reexamined, and predominant symptoms, treatment during one-year period, outcomes were evaluated. Results: Multiple logistic regression analysis revealed that one-year mortality after acute coronary syndromes was most influenced by age of 70-80 years, history of stroke, Killip class III-IV, and reduced high-density lipoprotein cholesterol levels. For patients who were treated for chronic coronary syndromes, reduced EF (<40%) and increased heart rate (>70 beats per minute) were the strongest independent predictors of one-year mortality. Conclusion: A scoring system for the assessment of mortality risk within one year for patients with acute and chronic coronary syndromes was constructed, which could be useful for cardiologists as well as family physicians for risk evaluation in inpatient and outpatient settings.