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Determinants and outcomes of coronary angiography after non-ST-segment elevation myocardial infarction. A cohort study of the Myocardial Ischaemia National Audit Project (MINAP)

J S Birkhead, C F M Weston, R Chen, Clive Weston Orcid Logo

Heart, Volume: 95, Issue: 19, Pages: 1593 - 1599

Swansea University Author: Clive Weston Orcid Logo

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Abstract

Using an observational study design we investigated determinants of, and outcomes from, coronary angiography and intervention in 13,489 admissions to 44 British hospitals with non-ST-segment elevation myocardial infarction (NSTEMI) between July 2005 to December 2006.Significantly lower rates of angi...

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Published in: Heart
ISSN: 1355-6037
Published: 2009
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URI: https://cronfa.swan.ac.uk/Record/cronfa10196
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spelling 2013-11-08T11:20:46.2082504 v2 10196 2012-03-21 Determinants and outcomes of coronary angiography after non-ST-segment elevation myocardial infarction. A cohort study of the Myocardial Ischaemia National Audit Project (MINAP) df85e4e0e139d0f46eb683174eba98a9 0000-0002-8995-8199 Clive Weston Clive Weston true false 2012-03-21 PMSC Using an observational study design we investigated determinants of, and outcomes from, coronary angiography and intervention in 13,489 admissions to 44 British hospitals with non-ST-segment elevation myocardial infarction (NSTEMI) between July 2005 to December 2006.Significantly lower rates of angiography were seen for women, the elderly, the most deprived and those having cardiac, and most non-cardiac, comorbidities. Performance of angiography, compared with no angiography, was not associated with lower rate of readmission (multiple adjusted hazard ratio (HR) = 0.96, 95% CI 0.74 to 1.24) unless accompanied by coronary intervention (HR = 0.73, 95% CI 0.56 to 0.95). Angiography was associated with reduction in 180-day mortality for survivors of hospitalisation (HR = 0.59, 95% CI 0.49 to 0.72); with greater reduction when followed by an intervention (HR = 0.34, 95% CI 0.28 to 0.42). This mortality benefit after intervention was seen both in women (HR = 0.42, 95% CI 0.29 to 0.60) and men (HR = 0.31, 95% CI 0.24 to 0.41), and across age groups: <65 years (HR = 0.25, 95% CI 0.14 to 0.44), 65-79 years (HR = 0.29, 95% CI 0.22 to 0.39) and > or =80 years (HR = 0.52, 95% CI 0.37 to 0.74). Mortality benefit was not significantly attenuated by the presence of comorbidities.Performance of angiography and coronary intervention after NSTEMI was associated with mortality benefit that persisted in the presence of both cardiac and non-cardiac comorbidities. Mortality benefit was seen across age groups and was similar for both sexes. Journal Article Heart 95 19 1593 1599 1355-6037 Acute coronary syndrome; 31 12 2009 2009-12-31 10.1136/hrt.2008.164426 COLLEGE NANME Medicine COLLEGE CODE PMSC Swansea University 2013-11-08T11:20:46.2082504 2012-03-21T16:17:18.0000000 Swansea University Medical School Medicine J S Birkhead 1 C F M Weston 2 R Chen 3 Clive Weston 0000-0002-8995-8199 4
title Determinants and outcomes of coronary angiography after non-ST-segment elevation myocardial infarction. A cohort study of the Myocardial Ischaemia National Audit Project (MINAP)
spellingShingle Determinants and outcomes of coronary angiography after non-ST-segment elevation myocardial infarction. A cohort study of the Myocardial Ischaemia National Audit Project (MINAP)
Clive Weston
title_short Determinants and outcomes of coronary angiography after non-ST-segment elevation myocardial infarction. A cohort study of the Myocardial Ischaemia National Audit Project (MINAP)
title_full Determinants and outcomes of coronary angiography after non-ST-segment elevation myocardial infarction. A cohort study of the Myocardial Ischaemia National Audit Project (MINAP)
title_fullStr Determinants and outcomes of coronary angiography after non-ST-segment elevation myocardial infarction. A cohort study of the Myocardial Ischaemia National Audit Project (MINAP)
title_full_unstemmed Determinants and outcomes of coronary angiography after non-ST-segment elevation myocardial infarction. A cohort study of the Myocardial Ischaemia National Audit Project (MINAP)
title_sort Determinants and outcomes of coronary angiography after non-ST-segment elevation myocardial infarction. A cohort study of the Myocardial Ischaemia National Audit Project (MINAP)
author_id_str_mv df85e4e0e139d0f46eb683174eba98a9
author_id_fullname_str_mv df85e4e0e139d0f46eb683174eba98a9_***_Clive Weston
author Clive Weston
author2 J S Birkhead
C F M Weston
R Chen
Clive Weston
format Journal article
container_title Heart
container_volume 95
container_issue 19
container_start_page 1593
publishDate 2009
institution Swansea University
issn 1355-6037
doi_str_mv 10.1136/hrt.2008.164426
college_str Swansea University Medical School
hierarchytype
hierarchy_top_id swanseauniversitymedicalschool
hierarchy_top_title Swansea University Medical School
hierarchy_parent_id swanseauniversitymedicalschool
hierarchy_parent_title Swansea University Medical School
department_str Medicine{{{_:::_}}}Swansea University Medical School{{{_:::_}}}Medicine
document_store_str 0
active_str 0
description Using an observational study design we investigated determinants of, and outcomes from, coronary angiography and intervention in 13,489 admissions to 44 British hospitals with non-ST-segment elevation myocardial infarction (NSTEMI) between July 2005 to December 2006.Significantly lower rates of angiography were seen for women, the elderly, the most deprived and those having cardiac, and most non-cardiac, comorbidities. Performance of angiography, compared with no angiography, was not associated with lower rate of readmission (multiple adjusted hazard ratio (HR) = 0.96, 95% CI 0.74 to 1.24) unless accompanied by coronary intervention (HR = 0.73, 95% CI 0.56 to 0.95). Angiography was associated with reduction in 180-day mortality for survivors of hospitalisation (HR = 0.59, 95% CI 0.49 to 0.72); with greater reduction when followed by an intervention (HR = 0.34, 95% CI 0.28 to 0.42). This mortality benefit after intervention was seen both in women (HR = 0.42, 95% CI 0.29 to 0.60) and men (HR = 0.31, 95% CI 0.24 to 0.41), and across age groups: <65 years (HR = 0.25, 95% CI 0.14 to 0.44), 65-79 years (HR = 0.29, 95% CI 0.22 to 0.39) and > or =80 years (HR = 0.52, 95% CI 0.37 to 0.74). Mortality benefit was not significantly attenuated by the presence of comorbidities.Performance of angiography and coronary intervention after NSTEMI was associated with mortality benefit that persisted in the presence of both cardiac and non-cardiac comorbidities. Mortality benefit was seen across age groups and was similar for both sexes.
published_date 2009-12-31T03:18:46Z
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