• E de Miguel-Balsa, A Baeza-Román, K Pino-Izquierdo, J Latour-Pérez, F J Coves-Orts, J M Alcoverro-Pedrola, M C Pavía-Pesquera, F Felices-Abad, R Calvo-Embuena, and Grupo ARIAM-SEMICYUC.
• Servicio de Medicina Intensiva, Hospital General Universitario de Elche, Elche, Alicante, España. Electronic address: emiguelbalsa@gmail.com.
• Med Intensiva. 2014 Nov 1; 38 (8): 483-91.

ObjectiveTo identify determinants associated to an early invasive strategy in women with acute coronary syndromes without ST elevation (NSTE-ACS).DesignA retrospective cohort study was made. Crude and adjusted analysis of the performance of the early invasive strategy using logistic regression.SettingCoronary Units enrolled in 2010 - 2011 in the ARIAM-SEMICYUC registry.PatientsA total of 440 women with NSTE-ACS were studied. Sixteen patients were excluded due to insufficient data, together with 58 patients subjected to elective coronary angiography (> 72 h).Variables AnalyzedDemographic parameters, coronary risk factors, previous medication, comorbidity. Clinical, laboratory, hemodynamic and electrocardiographic data of the episode.ResultsWomen treated conservatively were of older age, had oral anticoagulation, diabetes, previous coronary lesions, and heart failure (p<0.005), increased baseline bleeding and ischemic risk (p=0.05) and a higher heart rate upon admission (p<0.05). After adjustment, only age > 80 years (OR 0.48, 95% CI 0.27 to 0.82, p=0.009), known coronary lesions (OR 0.47, 95% CI 0.26-0.84, p=0.011), and heart rate (OR 0.98, 95% CI 0.97-0.99, p=0.003) were independently associated to conservative treatment. Smoking (OR 2.50, 95% CI 1.20 to 5.19, p=0.013) and high-risk electrocardiogram (OR 2.96, 95% CI 1.72 to 4.97, p<0.001) were associated to the early invasive strategy. The exclusion of early deaths (<24 h) did not alter these results.ConclusionsIn women with NSTE ACS, smoking and a high-risk electrocardiogram upon admission were independent factors associated to the early invasive strategy. Previous coronary lesions, age > 80 years and increased heart rate were independent factors associated to conservative treatment.Copyright © 2012 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

32 keywords...

hide…