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INFLUENCE OF PATIENTS’ PREHOSPITAL ATTENDANCE AT OUTPATIENT CLINICS ON LONG-TERM OUTCOMES OF ACUTE CORONARY SYNDROME: LIS-3 STUDY

https://doi.org/10.20996/1819-6446-2017-13-3-363-369

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Abstract

Aim. To assess influence of patients’ prehospital attendance at outpatient clinics on long-term outcomes of acute coronary syndrome (ACS).

Material and methods. Patients (n=397) hospitalized with ACS (01.11.2013-31.07.2015) were included. 19.4% of patients died in hospital (77/397).-According to their rate of attendance at outpatient clinics all survived patients (n=320) were divided into 3 groups: committed to visiting outpatient-clinics (n=139), partially committed (n=103) and not committed (n=78). Follow-up period was 14-35 months (88.44% follow-up rate). During-follow-up period 12.5% of patients died (40/320). All-cause mortality and recurrent cardiovascular diseases (nonfatal myocardial infarction and stroke,-unstable angina) were defined as the primary endpoint. Prognostic significance of separate factors and their combinations were assessed by their influence on the primary endpoint.

Results. Clinical severity of course of the disease was assessed regarding all factors that had influence on the primary endpoint. By their degree of influence on the primary endpoint each factor was given a certain score. According to the sum of all scores patients were divided into 2 groups: patients with less (n=205) and more (n=78) severe clinical course of the disease. Risk of development of primary endpoint was higher in patients with more severe clinical course of the disease (relative risk 3.997; 95% confidence interval 2.199-7.267; p <0.0001) regardless of patients’ attendance at outpatient-clinics (p>0.05).

Conclusion. Patients’ prehospital attendance at outpatient clinics did not affect long-term outcomes of acute coronary syndrome. Patients with more-severe clinical course of the disease were more likely to develop adverse outcomes during the follow-up regardless of their prehospital attendance at outpatient clinics.

About the Authors

Yu. V. Semenova
State Research Center for Preventive Medicine
Russian Federation

Yulia V. Semenova - MD, Graduate Student 

Petroverigsky per. 10, Moscow, 101990 



N. P. Kutishenko
State Research Center for Preventive Medicine
Russian Federation

Natalia P. Kutishenko - MD, PhD, Head of Laboratory for Pharmacoepidemiological Studies, Department of Preventive Pharmacotherapy 

Petroverigsky per. 10, Moscow, 101990 



A. V. Zagrebelnyy
State Research Center for Preventive Medicine
Russian Federation

Alexander V. Zagrebelnyy - MD, PhD, Senior Researcher, Department of Preventive Pharmacotherapy 

Petroverigsky per. 10, Moscow, 101990 



M. L. Ginzburg
Lyubertsy District Hospital №2
Russian Federation

Moisey L. Ginzburg - MD, PhD, Head of Cardiology Department 

Oktyabrskiy Prospect 338, Lyubertsy, Moscow Region 140006




A. D. Deev
State Research Center for Preventive Medicine
Russian Federation

Alexander D. Deev - PhD (in Physics and Mathematics), Head of Laboratory of Biostatistics 

Petroverigsky per. 10, Moscow, 101990 



S. Yu. Martsevich
State Research Center for Preventive Medicine
Russian Federation

Sergey Yu. Martsevich - MD, PhD, Professor, Head of Department of Preventive Pharmacotherapy 

Petroverigsky per. 10, Moscow, 101990 



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For citation:


Semenova Y.V., Kutishenko N.P., Zagrebelnyy A.V., Ginzburg M.L., Deev A.D., Martsevich S.Y. INFLUENCE OF PATIENTS’ PREHOSPITAL ATTENDANCE AT OUTPATIENT CLINICS ON LONG-TERM OUTCOMES OF ACUTE CORONARY SYNDROME: LIS-3 STUDY. Rational Pharmacotherapy in Cardiology. 2017;13(3):363-369. (In Russ.) https://doi.org/10.20996/1819-6446-2017-13-3-363-369

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ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)