Long term clinical outcome and bleeding complications among hospital survivors with acute coronary syndromes

Objective: To examine the 21 month clinical outcome and bleeding complications in hospital survivors with non-ST segment elevation acute coronary syndromes (NSTEACS) who were discharged with combined clopidogrel and aspirin anti-thrombotic therapy, and compare with those having ST segment elevation myocardial infarction (STEMI) who were discharged with aspirin alone. Design: Observational study. Setting: A large university hospital. Patients: 224 patients were admitted to hospital with either NSTEACS or STEMI, and survived to discharge between 1 October 2001 and 31 December 2002. Main outcome measures: Cardiovascular death, total death, new myocardial infarction, unstable angina requiring hospitalisation, stroke or transient ischaemic attack, coronary revascularisation; and fatal, life threatening, major and minor bleeding over 21 months after discharge. Results: Despite having no or small infarct (median maximum creatine kinase 155 v 1295 u/l; p