Ten-Year Mortality in Patients With ST-Elevation Myocardial Infarction

Am J Cardiol. 2021 Jun 15:149:9-15. doi: 10.1016/j.amjcard.2021.03.008. Epub 2021 Mar 20.

Abstract

Knowledge of the long-term prognosis (>10 years) and mortality predictors of ST-elevation myocardial infarction (STEMI) patients who have undergone primary percutaneous coronary intervention (p-PCI) is scarce. Therefore, this study evaluated the long-term prognosis and determined the predictors of long-term outcomes for STEMI patients after p-PCI. Between January, 2006 and December, 2010, we collected data and analyzed 459 consecutive patients with acute STEMI who underwent p-PCI and were discharged from the hospital (mean age, 66.8 years; male, 75.2%; peak creatine phosphokinase level, 2,292.5 IU/L). The primary endpoint was 10-year all-cause mortality. The cumulative 10-year incidence of all-cause death was 23.8%. The Cox multivariate regression analysis identified age ≥ 65 years (adjusted hazard ratio [aHR], p <0.001), body mass index (aHR, 0.93, p = 0.033), presence of atrial fibrillation (aHR, 1.69, p = 0.038), mineralocorticoid receptor antagonist use (aHR, 1.95, p = 0.008), ejection fraction <40% (aHR, 2.14, p = 0.005), and albumin <3.5 g/dL (aHR, 2.01, p = 0.005) as independent predictors of all-cause mortality. In conclusion, a post-discharge 10-year survival rate of 76.2% was identified for STEMI patients who underwent p-PCI.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Atrial Fibrillation / epidemiology*
  • Body Mass Index
  • Cause of Death
  • Female
  • Follow-Up Studies
  • Heart Diseases / mortality
  • Hemorrhage / mortality
  • Humans
  • Infections / mortality
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Mineralocorticoid Receptor Antagonists / therapeutic use*
  • Mortality
  • Multivariate Analysis
  • Neoplasms / mortality
  • Percutaneous Coronary Intervention*
  • Prognosis
  • Proportional Hazards Models
  • Protective Factors
  • Risk Factors
  • ST Elevation Myocardial Infarction / epidemiology
  • ST Elevation Myocardial Infarction / metabolism
  • ST Elevation Myocardial Infarction / physiopathology
  • ST Elevation Myocardial Infarction / surgery*
  • Serum Albumin / metabolism
  • Stroke / mortality
  • Stroke Volume / physiology

Substances

  • Mineralocorticoid Receptor Antagonists
  • Serum Albumin