Predictors of In-Hospital Mortality in Non-ST Elevation Acute Coronary Syndrome in Thai Acute Coronary Syndrome Registry (TACSR)†
Songsak Kiatchoosakun MD*, Chaiyasith Wongvipaporn MD*, Adisai Buakhamsri MD**, Sopon Sanguanwong MD***, Worachat Moleerergpoom, MD****, Pongdech Sarakarn*****, Songkwan Silaruks MD*, Pyatat Tatsanavivat MD*
Affiliation : † The Thai Acute Coronary Syndrome Registry (TACSR) * Division of Cardiology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen ** Division of Cardiology, Department of Medicine, Thammasat Chalermphakiat Hospital, Bangkok *** Division of Cardiology, Pramongkutklao Hospital, Bangkok **** Police General Hospital, Bangkok ***** Faculty of Public Health, Khon Kaen University, Khon Kaen
Objective : To determine baseline prognostic factors of in-hospital mortality in Thai patients with non-ST-
elevation acute coronary syndrome (NSTE-ACS).
Materials and Methods : Among 5,537 NSTE-ACS patients enrolled in Thai Acute Coronary Syndrome Registry,
a univariate analysis and multivariate analysis were used to estimate the relationship of baseline clinical
variables and in-hospital mortality. Variables examined included demographics, history and presenting
characteristics.
Results : The in-hospital mortality rate was 9.5%. The statistically significant, adjusted baseline prognostic
factors of in-hospital death were older age(> 65 years)(odds ratio [OR] 2.2, 95% confidence interval [CI] =
1.54-3.09), shock at presentation (OR 4.6, 95%CI = 2.91-7.32), heart failure (OR 3.1, 95%CI = 2.15-4.38),
positive cardiac marker (OR 1.7, 95%CI = 1.18-2.53), arrhythmia (OR 12.3, 95%CI = 8.71-17.35), major
bleeding (OR 2.9, 95%CI = 1.84-4.51), and cerebrovascular accident (OR 4.9, 95% CI = 2.42-9.97). While
dyslipidemia (OR 0.6, 95%CI = 0.45-0.87), having percutaneous coronary intervention (OR 0.6, 95% CI =
0.39-0.94), receiving aspirin (OR 0.6, 95%CI = 0.33-0.94), beta-blocker (OR 0.5, 95% CI = 0.40-0.73),
angiotensin converting enzyme inhibitor (OR 0.6, 95% CI = 0.43-0.78) and nitrate (OR 0.5, 95%CI = 0.35-
0.76) were associated with lower in-hospital mortality.
Conclusion : The in-hospital mortality is higher in Thai NSTE-ACS patients compared to other populations.
The present study supports and confirms the prognostics importance of several baseline characteristics reported
in previous studies.
Keywords : Acute coronary syndrome, Non-ST elevation, In hospital mortality, Predictor
