Dragana Radovanovic1, Lea Maurer2, Osmund Bertel3, Fabienne Witassek2, Philip Urban4, Jean-Christophe Stauffer5, Giovanni Pedrazzini6, Paul Erne7. 1. AMIS Plus Data Center, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland. Electronic address: dragana.radovanovic@uzh.ch. 2. AMIS Plus Data Center, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland. 3. Cardiology Center, Klinik im Park, Zurich, Switzerland. 4. Cardiovascular Department, La Tour Hospital, Geneva, Switzerland. 5. Service de Cardiologie, Hôpital Cantonal, Fribourg, Switzerland. 6. Division of Cardiology, Cardiocentro Ticino, Lugano, Switzerland. 7. AMIS Plus, Zurich, Switzerland.
Abstract
BACKGROUND: Little is known about differences in therapies and outcomes of patients with first myocardial infarction (MI) or recurrent MI (reMI). This study aimed to evaluate the impact of prior MI on therapies and outcomes in patients who presented with ST-elevation MI (STEMI). METHODS: All STEMI patients enrolled from 2002 to 2014 in the AMIS Plus registry were included. Outcome was analyzed using logistic multivariate regression. RESULTS: From 19,665 STEMI patients, 2845 (14%) had reMI. These patients were older (69.5y vs. 64.2y; p<0.001), more frequently male, with more risk factors (hypertension, dyslipidemia), and more comorbidities. Patients with reMI presented 25min earlier than those with first MI, were more frequently in Killip class 3/4 (12% vs. 7%; p<0.001), and were less likely to receive guideline-recommended drug therapy: aspirin (93% vs. 97%; p<0.001), P2Y12 inhibitors (76% vs. 83%; p<0.001), or statins (73% vs. 77%; p<0.001), or undergo primary percutaneous coronary intervention (77% vs. 87%; p<0.001). These patients developed more frequently cardiogenic shock (7% vs. 5%; p<0.001) and reinfarction (2% vs. 1%; p<0.001) during hospitalization, and had higher crude mortality (10% vs. 5%; p<0.001) than patients without prior MI. Prior MI was an independent predictor of in-hospital mortality in STEMI patients (OR 1.27; 95% CI 1.05-1.53; p<0.001). A subgroup (n=4486) was followed 1 year after discharge (3893 with first MI and 593 with reMI at initial hospitalization). Crude mortality was 2.9% for patients with first MI vs. 6.7% for those with reMI (OR 1.68, 95% CI 1.14-2.47; p=0.008). CONCLUSIONS: Although patients with reMI are high-risk patients, they were less likely to receive evidence-based treatment and had worse in-hospital and 1-year outcomes compared to patients with first MI. Short- and long-term management of patients with recurring MI should be improved.
BACKGROUND: Little is known about differences in therapies and outcomes of patients with first myocardial infarction (MI) or recurrent MI (reMI). This study aimed to evaluate the impact of prior MI on therapies and outcomes in patients who presented with ST-elevation MI (STEMI). METHODS: All STEMI patients enrolled from 2002 to 2014 in the AMIS Plus registry were included. Outcome was analyzed using logistic multivariate regression. RESULTS: From 19,665 STEMI patients, 2845 (14%) had reMI. These patients were older (69.5y vs. 64.2y; p<0.001), more frequently male, with more risk factors (hypertension, dyslipidemia), and more comorbidities. Patients with reMI presented 25min earlier than those with first MI, were more frequently in Killip class 3/4 (12% vs. 7%; p<0.001), and were less likely to receive guideline-recommended drug therapy: aspirin (93% vs. 97%; p<0.001), P2Y12 inhibitors (76% vs. 83%; p<0.001), or statins (73% vs. 77%; p<0.001), or undergo primary percutaneous coronary intervention (77% vs. 87%; p<0.001). These patients developed more frequently cardiogenic shock (7% vs. 5%; p<0.001) and reinfarction (2% vs. 1%; p<0.001) during hospitalization, and had higher crude mortality (10% vs. 5%; p<0.001) than patients without prior MI. Prior MI was an independent predictor of in-hospital mortality in STEMI patients (OR 1.27; 95% CI 1.05-1.53; p<0.001). A subgroup (n=4486) was followed 1 year after discharge (3893 with first MI and 593 with reMI at initial hospitalization). Crude mortality was 2.9% for patients with first MI vs. 6.7% for those with reMI (OR 1.68, 95% CI 1.14-2.47; p=0.008). CONCLUSIONS: Although patients with reMI are high-risk patients, they were less likely to receive evidence-based treatment and had worse in-hospital and 1-year outcomes compared to patients with first MI. Short- and long-term management of patients with recurring MI should be improved.
Authors: Per-Jostein Samuelsen; Anne Elise Eggen; Terje Steigen; Tom Wilsgaard; Andreas Kristensen; Anne Skogsholm; Elizabeth Holme; Christian van den Heuvel; Jan Erik Nordrehaug; Bjørn Bendz; Dennis W T Nilsen; Kaare Harald Bønaa Journal: PLoS One Date: 2021-03-04 Impact factor: 3.240
Authors: Suzanne Machta; Victoria Gauthier; Jean Ferrières; Michèle Montaye; Samantha Huo Yung Kai; Stefy Gbokou; Katia Biasch; Marie Moitry; Philippe Amouyel; Jean Dallongeville; Aline Meirhaeghe Journal: PLoS One Date: 2022-02-14 Impact factor: 3.240
Authors: Helena Tizón-Marcos; Beatriz Vaquerizo; Josepa Mauri Ferré; Núria Farré; Rosa-Maria Lidón; Joan Garcia-Picart; Ander Regueiro; Albert Ariza; Xavier Carrillo; Xavier Duran; Paul Poirier; Mercè Cladellas; Anna Camps-Vilaró; Núria Ribas; Hector Cubero-Gallego; Jaume Marrugat Journal: Front Cardiovasc Med Date: 2022-04-25