AIM: In 2002 the ACC/AHA guidelines for the management of @entity1 with @entity1459 ( @entity1459 ) and @entity583 ( @entity583 ) were updated. We aimed to answer whether the implementation of updated guidelines was capable of influencing short- and long-term mortality in these @entity1 . METHODS: We analyzed data on 812 consecutive @entity1 who were admitted with either @entity1459 or @entity583 between 2001 and 2004. @entity1 admitted in the two years before the implementation of updated guidelines ( @entity1459 (01/02) group and @entity583 (01/02) group) were compared to @entity1 admitted in the two years thereafter ( @entity1459 (03/04) group and @entity583 (03/04) group). Yearly follow-up concerning all-cause mortality was obtained up to four years. RESULTS: The rate of revascularizations, the percentage of procedures performed within 48 h of admission, and the administration of @entity1397 increased significantly. However, still many - especially high-risk - @entity1 did not receive revascularization. @entity1 of both @entity1459 groups had an identical in-hospital mortality rate. Differences in mortality between groups gained statistical significance over time (four-year mortality; 15.1% for the @entity1459 (03/04) group vs. 26.5% for the @entity1459 (01/02) group, p=0.014; HR 0.49 95% CI 0.28-0.87). In @entity1 with @entity583 in-hospital mortality decreased from 18.4% in the @entity583 (01/02) group to 9.6% in the @entity583 (03/04) group (p=0.011; HR 0.47 95% CI 0.26-0.84), and 1-year mortality from 34.7% to 25.1% (p=0.038; HR 0.63 95% CI 0.41-0.98), respectively. Mortality rates beyond one year were still lower in the @entity583 (03/04) group as compared to the @entity583 (01/02) group but it did not reach statistical significance. Multivariate Cox-regression analysis revealed furthermore that also @entity1 with higher age and/or renal dysfunction benefit from an early invasive strategy. CONCLUSION: The implementation of updated guidelines for @entity12300 had significant impact on short- and long-term mortality. However, an early invasive strategy is still withheld to a significant number of high-risk @entity1 , who would benefit from an invasive treatment.

Influence of updated guidelines on short- and long-term mortality in @entity1 with non-ST-segment elevation acute coronary syndrome ( XXXX ).

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity1397 :: ('MESH:C055162', 'Chemical') :: ['clopidogrel'] @entity1459 :: ('MESH:D000789', 'Disease') :: ['UA', 'unstable angina'] @entity12300 :: ('84680', 'Gene') :: ['NSTE-ACS'] @entity583 :: ('MESH:D009203', 'Disease') :: ['NSTEMI', 'non-ST-segment elevation myocardial infarction']
@entity12300 :: (84680,Gene) :: ['NSTE-ACS']
