Regular paperPrognosis in the Thrombolysis in Myocardial Ischemia III Registry according to the Braunwald unstable angina pectoris classification
Section snippets
Methods
The details of the Thrombolysis in Myocardial Ischemia III Registry have been previously reported.10 Briefly, patients admitted between October 1990 and April 1993 with a diagnosis of UAP or NSTEMI at 14 tertiary care hospitals in the United States and Canada were screened for inclusion on an enumeration roster. Inclusion criteria were an episode of either resting or exertional pain presumed to be ischemic in origin, lasting >5 minutes, occurring within 96 hours before enrollment. If
Results
Overall, in the Thrombolysis in Myocardial Ischemia III Registry, the mean age was 61.5 years, 58.3% of patients were men, 51.0% had hypertension, 24.2% had diabetes mellitus, and 21.2% of patients were determined to have a NSTEMI at presentation.10
Each of the Braunwald subgroups was well represented in the registry. Two thousand two hundred forty-eight patients (73.7%) had primary UAP, 708 (21.3%) had secondary UAP, and 164 (4.9%) had post-MI UAP. Most of the patients (2,563 patients, 77.3%)
Discussion
The principal goal of the Braunwald classification was to identify patients with a higher risk of adverse events and to provide them with the most appropriate and aggressive care. The Thrombolysis in Myocardial Ischemia III Registry is the first large multicenter study that has prospectively validated all aspects of this classification. As hypothesized, the severity of UAP at presentation and the clinical circumstance leading to UAP successfully predicted prognosis. Specifically, patients who
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