Clinical features and prognostic factors in Korean patients hospitalized for coronary artery disease (Catholic Heart Care Network Study)

Cho, Jin Man; Kim, Chong Jin; Shin, Woo Seung; Cho, Eun Ju; Park, Chul Soo; Kim, Pum Joon; Lee, Jong Min; Ihm, Sang Hyun; Rhim, Hyou Young; Chang, Kiyuk; Moon, Keon Woong; Kim, Yong Ju; Jung, Hae Ok; Kim, Hee Yeol; Park, Ji Won; Jin, Seung Won; Jeon, Hui Kyung; Oh, Yong Seog; Yoo, Ki Dong; Jeon, Doo Soo; Baek, Sang Hong; Lee, Gil Whan; Youn, Ho Joong; Lee, Man Young; Chung, Wook Sung; Park, Jun Chul; Seung, Ki Bae; Rho, Tai Ho; Kim, Chul Min; Park, In Soo; Chae, Jang Seong; Kim, Jae Hyung; Choi, Kyu Bo; Hong, Soon Jo

Abstract

BACKGROUND: Coronary artery disease (CAD) has recently become one of the major causes of mortality and morbidity in Korea. However, not much epidemiologic and demographic data has yet been reported. The purpose of this study was to investigate the clinical features as well as the prognostic factors of patients with CAD.
METHODS
We prospectively enrolled 1,665 consecutive patients with CAD who had been admitted to the Catholic University Hospitals from December 1999 to April 2003.
RESULTS
Acute myocardial infarction (AMI) was the most common cause of admission (n=715, 42.9%). Dyslipidemia, hypertension and smoking were the most common risk factors. More than 70% of the patients who underwent percutaneous coronary intervention (PCI) received stent implantation. A total of 965 (612 males) patients were followed at least for 6 months (the mean follow-up duration was 23.8+/-12.2 months). The incidence rates of major adverse cardiac events (MACE: cardiac death, acute myocardial infarction, target vessel revascularization) and cardiac death were 15.1% (n=146) and 2.2% (n=21), respectively. There was no difference in overall survival between the patients treated with medical therapy and those treated with PCI. By Cox regression analysis, the independent prognostic factors for MACE were PCI (95% CI: 1.75-4.85; p<0.01) and multivessel disease (95% CI: 1.03-2.04; p<0.05), and the independent prognostic factors for cardiac death were medical therapy (95% CI: 1.08-14.41; p<0.05) and old age (95% CI: 1.13-16.13; p<0.05).
CONCLUSIONS
There was no difference in overall survival between the patients treated with medical therapy and those treated with PCI. However, PCI was superior to medical therapy for preventing death of the patients with acute coronary syndrome.