Objective: To evaluate the incidence of cardiac events and survival in patients with first acute coronary syndromes during 5-year period.
Methods and results: Data on 732 patients admitted with first acute coronary syndrome were collected in a database. During hospitalization period 45.4% of the patients received reperfusion therapy. During follow-up period (4.49+/-2.1 years) 215 (29.4%) patients had cardiac events: 15.3%--myocardial revascularization, 8.1%--repeated myocardial infarction, 11.5%--cardiovascular deaths. The highest (5%) mortality rate was during first year, whereas during the following four years--1.5% annually. Kaplan-Meier analysis for survival free of cardiovascular death revealed that mortality rates were higher among patients who were > or =65 years old (long-rank test, p=0.02); had heart failure at admission (p=0.003), left ventricular ejection fraction <40% (p=0.04), significance diastolic dysfunction (p=0.035), III-IV degrees mitral regurgitation (p=0.00006); did not received reperfusion therapy (p=0.007).
Conclusion: The analysis of this long-term follow-up data shows that the patients with acute coronary syndromes carry a high risk of death and need better treatment strategies to reduce risk.