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F. Cavuto, G. Berton, H. Mahmoud, M. Mahmoud, R. Cordiano, R. Palmieri, F. Bagato, A. Cati, G. Allocca
BASSANO DEL GRAPPA GENERAL HOSPITAL, BASSANO DEL GRAPPA; CONEGLIANO GENERAL HOSPITAL, CONEGLIANO; THE ABC HEART DISEASE FOUNDATION, CONEGLIANO; MINIA UNIVERSITY HOSPITAL, MINIA; ADRIA GENERAL HOSPITAL, ADRIA; FELTRE GENERAL HOSPITAL, FELTRE; CONEGLIANO GENERAL HOSPITAL, CONEGLIANO

Purpose: To assess the eect of Beta–blocker time intensity treatment (BB TIT) on the long–term mortality risk after acute coronary syndrome (ACS) through 20 years of follow–up.

Methods: This study includes 589 patients with ACS enrolled in three centres and discharged alive. Baseline clinical and laboratory data were gathered within the first 7 days of hospitalization. Survival analysis using Cox regression analysis model was done to investigate the long term prognostic value of BB TIT after ACS.

Results: During 20 years o ollow–up, 437 (74.1%) patients died; they were significantly dierent for many clinical features from living patients. During follow–up BB TIT percent was higher among living patients 55 6 38 vs. 30 6 41 for the patients who died. 196 (33%) patients had heart failure (HF) at admission and their BB TIT percent was lower comparing to patients who did not presented with HF (43 6 41 vs. 25 6 39) respectively. At Cox regression analysis using a model adjusted for age, gender, DM, heart rate at admission, diabetes, HF and albuminuria BB TIT showed a long term protective eect (HR ¼0.9 (95%CI¼0.993–0.998)
p¼0.002). Using the same model, similar eect was observed among patients who did not have HF (HR ¼0.9 (95%CI¼0.991–0.998) p ¼0.007) but not among patients who suered from HF at admission (HR ¼0.9 (95%CI¼0.993–1.0) p¼0.22). Likewise, BB TIT showed a protective eect in patients who did not have albuminuria at admission but not for patients who did (HR ¼0.9 (95%CI¼0.989–0,997) p ¼0.002) and (HR ¼0.9 (95%CI¼0.993–1.0) p ¼0.10).

Conclusions: Beta–blocker time intensity treatment across 20 years o ollow up after ACS seems to be more protective for global mortality in the non–severely ill patients and less protective in severely ill patients.

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Welcome

In 1992, a small group of medical researchers and other participants embarked on an project to investigate new clinical factors for heart disease, studying patients with acute coronary syndrome and following them for many years. Today, the observations on the long-term survival after acute coronary syndrome are internationally acknowledged. Main results appears on the most important cardiovascular texts across the world. The study is called “the ABC heart disease study”.

Nel 1992, un piccolo gruppo di medici ricercatori ed altri operatori sanitari, iniziarono un progetto per studiare nuovi fattori clinici della malattia cardiaca, studiando pazienti con sindrome coronarica acuta e seguendoli per molti anni. Oggi, ciò che è stato osservato sulla sopravvivenza a lungo temine dopo sindrome coronarica acuta è riconosciuto a livello internazionale. I principali risultati appaiono sui maggiori testi di medicina cardiovascolare in tutto il mondo. Questo progetto è stato chiamato “the ABC heart disease study”.

Mission

The Mission of the ABC Study on Heart Disease Project is to promote the knowledge on heart disease chiefly based on the long-term follow up of the patients. And to promote citizen health supporting preventive, social, and sport activities.