■现实世界的不稳定型心绞痛（UA）在高敏肌钙蛋白时代的结果尚不清楚。我们的目的是调查与稳定型心绞痛（SA）相比，冠状动脉造影的UA的结局。非ST段抬高型心肌梗死(NSTEMI),STEMI和普通人群。
■我们纳入了2013年至2018年挪威北部9,694例无冠状动脉疾病（CAD）的患者（51％SA，12%UA，23%NSTEMI和14%STEMI)，以及从Tromsø研究中招募的11,959名无症状个体。我们使用Cox模型来估计全因死亡率和主要不良心血管事件（MACE）的风险比（HR）。定义为心血管死亡，MI或阻塞性CAD。
■中位随访时间为2.8年。一般人群的死亡率为8.5/1000人年（95％置信区间[CI]8.0-9.0），SA中为9.7（95%CI8.3-11.5），UA中14.9（95%CI11.4-19.6），NSTEMI为29.7（95%CI25.6-34.3），STEMI为36.5（95%CI30.9-43.2）。在多变量调整分析中，与UA相比，SA的死亡风险降低了38％，MACE的风险也没有显着降低（HR0.62，95％CI0.44-0.89；HR0.86，95％CI0.66-1.11）。NSTEMI在冠状动脉造影后的第一年与毒性UA相比，死亡风险高2.4倍（HR2.39，95％CI1.38-4.14），MACE风险高1.6倍（HR1.62，95％CI1.11-2.38），但此后有类似的风险。非阻塞性CAD和阻塞性CAD的UA死亡风险无差异（HR0.78，95％CI0.39-1.57）。
与SA相比，UA的死亡风险较高，但MACE风险相似，与NSTEMI相比，1年死亡和MACE风险较低。
UNASSIGNED: The outcomes of real-world unstable angina (UA) in the high-sensitivity troponin era are unclear. We aimed to investigate the outcomes of UA referred to coronary angiography compared to stable angina (SA), non-ST-segment elevation myocardial infarction (NSTEMI), STEMI and a general population.
UNASSIGNED: We included the 9,694 patients with no prior coronary artery disease (CAD) referred to invasive or CT coronary angiography from 2013 to 2018 in Northern Norway (51% SA, 12% UA, 23% NSTEMI and 14% STEMI), and 11,959 asymptomatic individuals recruited from the Tromsø Study. We used Cox models to estimate the hazard ratios (HR) for all-cause mortality and major adverse cardiovascular events (MACE), defined as cardiovascular death, MI or obstructive CAD.
UNASSIGNED: The median follow-up time was 2.8 years. The incidence rate of death was 8.5 per 1000 person-years (95 % confidence interval [CI] 8.0-9.0) in the general population, 9.7 (95 % CI 8.3-11.5) in SA, 14.9 (95 % CI 11.4-19.6) in UA, 29.7 (95 % CI 25.6-34.3) in NSTEMI and 36.5 (95 % CI 30.9-43.2) in STEMI. In multivariable adjusted analyses, compared with UA, SA had a 38 % lower risk of death and a non-significant lower risk of MACE (HR 0.62, 95 % CI 0.44-0.89; HR 0.86, 95 % CI 0.66-1.11). NSTEMI had a 2.4-fold higher risk of death (HR 2.39, 95 % CI 1.38-4.14) and a 1.6-fold higher risk of MACE (HR 1.62, 95 % CI 1.11-2.38) compared tox UA during the first year after coronary angiography, but a similar risk thereafter. There was no difference in the risk of death for UA with non-obstructive CAD and obstructive CAD (HR 0.78, 95 % CI 0.39-1.57).
UNASSIGNED: UA had a higher risk of death but a similar risk of MACE compared to SA and a lower 1-year risk of death and MACE compared to NSTEMI.
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