American Heart Journal
Volume 148, Issue 1 , Pages 62-71 , July 2004

Dynamic prognostication in non-ST–elevation acute coronary syndromes: insights from GUSTO-IIB and pursuit

  • Wei-Ching Chang, PhD

      Affiliations

    • University of Alberta, Edmonton, Alberta, Canada
    • ,
  • Eric Boersma, PhD

      Affiliations

    • Erasmus University, Rotterdam, The Netherlands
    • ,
  • Christopher B Granger, MD

      Affiliations

    • Duke Clinical Research Institute, Durham, NC, USA
    • ,
  • Robert A Harrington, MD

      Affiliations

    • Duke Clinical Research Institute, Durham, NC, USA
    • ,
  • Robert M Califf, MD

      Affiliations

    • Duke Clinical Research Institute, Durham, NC, USA
    • ,
  • Maarten L Simoons, MD

      Affiliations

    • Erasmus University, Rotterdam, The Netherlands
    • ,
  • Neal S Kleiman, MD

      Affiliations

    • Baylor College of Medicine, Houston, Tex, USA
    • ,
  • Paul W Armstrong, MD

      Affiliations

    • University of Alberta, Edmonton, Alberta, Canada
    • Corresponding Author InformationReprint requests: Paul W. Armstrong, MD, Department of Medicine, 2-51 Medical Sciences Building, University of Alberta, Edmonton, Alberta T6G 2H7 Canada.
    • ,
  • GUSTO-IIb and PURSUIT Investigators

Received 27 December 2002 ,Accepted 14 May 2003.

References 

  1. ACC/AHA guideline update for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients with Unstable Angina). J Am Coll Cardiol 2002;40:1366–74
  2. Peterson ED, Shaw LJ, Califf RM. Risk stratification after myocardial infarction. Ann Intern Med. 1997;126:561–582
  3. Antman EM, Cohen M, Bernink PJL, et al.  The TIMI risk score for unstable angina/non-ST elevation MI (a method for prognostication and therapeutic decision making). JAMA. 2000;284:835–842
  4. Boersma E, Pieper KS, Steyerberg EW, et al.  Predictors of outcome in patients with acute coronary syndromes without persistent ST-segment elevation (results from an international trial of 9461 patients). Circulation. 2000;101:2557–2567
  5. Lee KL, Woodlief LH, Topol EJ, et al.  Predictors of 30-day mortality in the era of reperfusion for acute myocardial infarction (results from an international trial of 41,021 patients). Circulation. 1995;91:1659–1668
  6. Morrow DA, Antman EM, Charlesworth A, et al.  TIMI risk score for ST-elevation myocardial infarction (a convenient, bedside, clinical score for risk assessment at presentation). Circulation. 2000;102:2031–2037
  7. Lenderink T, Simoons ML, Van Es A, et al.  Benefit of thrombolytic therapy is sustained throughout five years and is related to TIMI perfusion grade 3 but not grade 2 flow at discharge. Circulation. 1995;92:1110–1116
  8. The GUSTO-IIb Investigators . A comparison of recombinant hirudin with heparin for the treatment of acute coronary syndromes. N Engl J Med. 1996;335:775–782
  9. Armstrong PW, Fu Y, Chang W-C, et al.  Acute coronary syndromes in the GUSTO-IIb trial (prognostic insights and impact of recurrent ischemia). Circulation. 1998;98:1860–1868
  10. The PURSUIT Investigators . Inhibition of platelet glycoprotein IIb/IIIa with eptifibatide in patients with acute coronary syndromes. N Engl J Med. 1998;339:436–443
  11. Kaul P, Fu Y, Chang W-C, et al.  Prognostic value of ST-segment depression in acute coronary syndromes (insights from PARAGON-A applied to GUSTO-IIb). J Am Coll Cardiol. 2001;38:64–71
  12. Lemeshow S, Teres D, Spitz Avrunin J, et al.  Refining intensive care unit outcome prediction by using changing probabilities of mortality. Crit Care Med. 1988;16:470–477
  13. Pozen MW, D'Agostino RB, Selker HP, et al.  A predictive instrument to improve coronary-care-unit admission practices in acute ischemic heart disease (a prospective multicenter clinical trial). N Engl J Med. 1984;310:1273–1278
  14. Selker HP, Beshansky JR, Griffith JL, et al.  Use of the acute cardiac ischemia time-insensitive predictive instrument (ACI-TIPI) to assist with triage of patients with chest pain or other symptoms suggestive of acute cardiac ischemia (a multicenter, controlled clinical trial). Ann Intern Med. 1998;129:845–855
  15. Goldman L, Cook EF, Johnson PA, et al.  Prediction of the need for intensive care in patients who came to emergency department with acute chest pain. N Engl J Med. 1996;334:1498–1504
  16. Knaus WA, Wagner DP, Draper EA, et al.  The APACHE III prognostic system (risk prediction of hospital mortality for critically ill hospitalized adults). Chest. 1991;100:1619–1636
  17. Knaus WA, Draper EA, Wagner DP, et al.  An evaluation of outcome from intensive care in major medical centers. Ann Intern Med. 1986;104:410–418
  18. Rapoport J, Teres D, Lemeshow S, et al.  A method for assessing the clinical performance and cost-effectiveness of intensive care units (a multicenter inception cohort study). Crit Care Med. 1994;22:1385–1391
  19. Markgraf R, Deutschinoff G, Pientka L, et al.  Comparison of acute physiology and chronic health evaluations II and III and Simplified Acute Physiology Score II (a prospective cohort study evaluating these methods to predict outcome in a German interdisciplinary intensive care unit). Crit Care Med. 2000;28:26–33
  20. Cannon CP, Weintraub WS, Demopoulos LA, et al.  Comparison of early invasive and conservative strategies in patients with unstable coronary syndromes treated with the glycoprotein IIb/IIIa inhibitor tirofiban. N Engl J Med. 2001;344:1879–1887
  21. The FRISC II Investigators . Invasive compared with non-invasive treatment in unstable coronary-artery disease (FRISC II prospective randomised multicentre study). Lancet. 1999;354:708–715
  22. The TIMI-IIIB Investigators . Effects of tissue plasminogen activator and a comparison of early invasive and conservative strategies in unstable angina and non-Q-wave myocardial infarction. Results of the TIMI-IIIB trial. Circulation. 1994;89:1545–1556
  23. Boersma E, Harrington RA, Moliterno DJ, et al.  Platelet glycoprotein IIb/IIIa inhibitors in acute coronary syndromes (a meta-analysis of all major randomised clinical trials). Lancet. 2002;359:189–198
  24. Antman EM. The search for replacements for unfractionated heparin. Circulation. 2001;103:2310–2314
  25. Muhlbaier LH, Pryor DB, Rankin JS, et al.  Observational comparison of event-free survival with medical and surgical therapy in patients with coronary artery disease (20 years follow-up). Circulation. 1992;86(5 Suppl):II198–204
  26. Mark DB, Sigmon K, Topol EJ, et al.  Identification of acute myocardial infarction patients suitable for early hospital discharge after aggressive interventional therapy. Circulation. 1991;83:1186–1193
  27. Newby LK, Califf RM, Guerci A, et al.  Early discharge in the thrombolytic era (an analysis of criteria for uncomplicated infarction from the GUSTO trial). J Am Coll Cardiol. 1996;27:625–632
  28. The GUSTO-IIb Angioplasty Substudy Investigators . A clinical trial comparing primary coronary angioplasty with tissue plasminogen activator for acute myocardial. N Engl J Med. 1997;336:1621–1628
  29. Kleiman NS, Lincoff AM, Flaker GC, et al.  Early percutaneous coronary intervention, platelet inhibition with eptifibatide, and clinical outcomes in patients with acute coronary syndromes. Circulation. 2000;101:751–757
  30. The IMPACT-II Investigators . Randomised placebo-controlled trial of effect of eptifibatide on complications of percutaneous coronary intervention (IMPACT-II). Lancet. 1997;349:1422–1428
  31. Alexander JH, Harrington RA, Tuttle RH, et al.  Prior aspirin use predicts worse outcomes in patients with non-ST elevation acute coronary syndromes. Am J Cardiol. 1999;83:1147–1151
  32. Arnold AER, Simoons ML. Thrombolytic therapy for evolving myocardial infarction needs an approach that integrates benefit and risk. Eur Heart J. 1995;16:1502–1509
  33. Kong DF, Lee KL, Harrell FE, et al.  Clinical experience and predicting survival in coronary disease. Arch Intern Med. 1989;149:1177–1181
  34. Pryor DB, Shaw L, McCants CB, et al.  Value of the history and physical in identifying patients at increased risk for coronary artery disease. Ann Intern Med. 1993;118:81–90

☆ Guest Editor for this manuscript was Elliott M. Antman, MD, Brigham and Women's Hospital, Boston, Mass.

PII: S0002-8703(04)00108-5

doi: 10.1016/j.ahj.2003.05.004

American Heart Journal
Volume 148, Issue 1 , Pages 62-71 , July 2004

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