Coronary disease & ACS

Long-term cardiovascular outcomes in patients hospitalised with acute coronary syndrome subtypes in Western Australia, 2002–2019

HeartPublished Linked hospitalisation and mortality data cohort

Authors' conclusion

Long-term risk of MACE and all-cause death remains high and unchanged among 30-day survivors of all ACS subtypes in the recent era. Long-term surveillance and optimal secondary prevention are important in survivors of all ACS subtypes.

Study context

Population
30-day survivors of index STEMI, non-STEMI (NSTEMI) and unstable angina (UA) hospitalisation in Western Australia between 2002 and 2019patients with acute coronary syndrome (ACS), 65% males
Participants
73,321 survivors
Exposure
NSTEMI vs STEMI and UA; STEMI or NSTEMI versus UA
Outcome
Cohort composition by ACS subtype
Methodological detailsCox proportional hazards modelling after adjustment for potential confounders
  • Cox proportional hazards modelling after adjustment for potential confounders

Main finding

As reported in the abstract

GroupValueMean age
STEMI22.3%63.2
NSTEMI43.2%68.8
UA34.6%66.4

Value

STEMI22.3%
NSTEMI43.2%
UA34.6%

Mean age

STEMI63.2
NSTEMI68.8
UA66.4

Observational data: associations, not effects.

Further findings

Cumulative MACE (non-fatal MI, stroke, heart failure hospitalisation or cardiovascular death) · 5-year

All-cause mortality · 5-year

  • Cumulative major adverse cardiovascular events (MACE) (non-fatal MI, stroke, heart failure hospitalisation or cardiovascular death): log-rank p<0.001
  • All-cause mortality: log-rank p<0.001

Temporal trend in multivariable-adjusted risk of outcomes

No temporal improvement for all ACS subtypes throughout the study period

Adjusted HRs for MACE and all-cause death, STEMI or NSTEMI versus UA, in males and females

Adjusted HRs 1.5-fold or higher
1.5-fold or higher

Baseline characteristics

Patients with NSTEMI and UA compared with STEMI were more likely to be female with additional comorbidities

Original publication

Long-term cardiovascular outcomes in patients hospitalised with acute coronary syndrome subtypes in Western Australia, 2002–2019. Heart. Published 25 June 2026. doi:10.1136/heartjnl-2026-327843

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