Inclusion: a patient must meet all criteria | |
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1 | Age ≥40 years |
2 | Symptoms of typical ischaemic chest pain, lasting 10 min or more within the preceding 24 hours prior to presentation |
3a | ECG: (non-)persistent ST segment elevation >1.0 mm in two or more contiguous leads, or dynamic ST segment depression >1.0 mm in two or more contiguous leads, OR 3b Biochemical evidence of myocardial injury: CKMB or (high-sensitivity) troponin I or (high-sensitivity) troponin T elevation according to the applicable ESC guidelines of non ST-elevation acute coronary syndromes |
4 | Presence of at least one of the following risk factors: age ≥75 years, diabetes, prior cardiovascular disease, prior cerebrovascular disease and prior peripheral arterial disease. In addition, other risk factors mentioned below can be considered as well, but each only counts as half a risk factor, that is, two of these are required for inclusion: age ≥65 years in men, age ≥70 years in women, hypertension, hypercholesterolaemia, current smoking or microalbuminuria,* positive family history of coronary artery disease.† |
5 | Written informed consent |
Exclusion: a patient cannot be included in case of any of the criteria below | |
1 | Myocardial ischaemia precipitated by a condition other than atherosclerotic coronary artery disease |
2 | Left ventricular ejection fraction <30%, or end-stage congestive heart failure (NYHA class III or IV) |
3 | Renal dialysis, or severe chronic kidney disease with measured or calculated GFR (Cockroft-Gault or MDRD4 formula) of <30 mL/min/1.73 m2 |
4 | Coexistent condition with life expectancy <1 year or otherwise not expected to complete follow-up |
*Defined as >2.5 to 25 mg albumin/mmol creatinine for men and >3.5 to 35 mg for women, or >20 to 200 mg/L urinary albumin concentration in a single urine sample.
†Angina pectoris, myocardial infarction or sudden abrupt death without obvious cause, before the age of 55 in a first-degree blood relative.
GFR, glomerular filtration rate; MDRD, Modification of Diet in Renal Disease; NYHA, New York Heart Association classification.