The influence of early invasive strategy on the long-term prognosis in patients with acute coronary syndromes and the analysis of risk factors

Aim:To explore the influence of early invasive strategy on the long-term prognosis in patients with acute coronary syndroms(ACS) and analyse the risk factors.Methods:Patients with ACS hospitalized from 2001 to 2002 were selected and categoried into early invasive strategy(PCI)and early conservative strategy according to treatment.A follow-up study was carried out.The end events is major adverse cardiovascular events(MACE,cardiac death,nonfatal myocardial infarction and recurrent ischemia angina).The follow-up time was at least 12 months.The difference in prognosis between the two groups was analyzed.Common risk factors were measured in the follow-up patients and the primary risk factors for MACE were evaluated by multivariate logistic regression analysis.Results:A total 153 patients(66 in PCI and 87 in early conservative strategy) were followed up.The average follow-up time was 46 months,then the shortest and the longest follow-up time was 19 months,56 months respectively.54.6% of patients were followed up for at least 36 months.The incidence of nonfatal myocardial infarction and total cardiovascular events were 8.5%, 21.6% and 32.9%,48.3% respectively,P0.05;the death rate was 7.3%,8.3% respectively and no significant difference was found.Multivariate logistic regression analysis demonstrated a compact association between age,increased hsCRP、blood glucose level,Tc level and MACE,and they were respectively independent predictive factors for the increase of MACE.Conclusion:Early invasive strategy can significantly reduce the incidence of nonfatal myocardial infarction and total cardiovascular events in patients with ACS.Age,increased hsCRP,blood glucose level and Tc level are risk factors for the long-term prognosis.