Risk of early recurrence and mortality in high-risk myocardial infarction patients: A population-based linked data study
Background: Survival during the early period following myocardial infarction (MI) has significantly improved although there are limited data on cardiovascular recurrence during this period. Methods: We identified all emergency hospitalisations for MI from November 1, 2011 to October 31, 2016 in West...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-06-01
|
| Series: | International Journal of Cardiology. Cardiovascular Risk and Prevention |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772487523000181 |
| _version_ | 1797823055616016384 |
|---|---|
| author | Lee Nedkoff Tom Briffa Kevin Murray James Gaw Andrea Yates Frank M. Sanfilippo Stephen J. Nicholls |
| author_facet | Lee Nedkoff Tom Briffa Kevin Murray James Gaw Andrea Yates Frank M. Sanfilippo Stephen J. Nicholls |
| author_sort | Lee Nedkoff |
| collection | DOAJ |
| description | Background: Survival during the early period following myocardial infarction (MI) has significantly improved although there are limited data on cardiovascular recurrence during this period. Methods: We identified all emergency hospitalisations for MI from November 1, 2011 to October 31, 2016 in Western Australia from a linked hospitalisation/mortality dataset. Patients were included if they survived >3 days, had no acute kidney injury, and had ≥1 of: ≥65 years, prior MI, diabetes or peripheral arterial disease. Outcomes were major adverse cardiovascular events (MACE, a composite of CVD death, recurrent MI or stroke), cardiovascular disease (CVD) death, all-cause mortality, recurrent MI and stroke. Cumulative risks at 90-days and 1-year were estimated from Kaplan-Meier analyses and predictors of each outcome from multivariable Cox regression models. Results: There were 8024 high-risk MI patients identified (males 61.8%). Median age was 73.7 years (IQR 66.3–82.2). Half of the risk of MACE occurred in the first 90-days post-MI (6.6% vs 12.6% at 1-year) and was underpinned by risk of recurrent MI. Risk was generally higher in women than men (MACE: 6.0% males, 7.7% females, p = 0.0025; CVD mortality: 1.7% males, 3.7% females; all-cause mortality: 2.8% males, 5.6% females, p < 0.0001). Independent predictors of 90-day MACE were increasing age, heart failure history, hypertension and prior stroke. Female sex was not associated with a higher rate of any of the outcomes after multivariable adjustment. Conclusion: Half of cardiovascular events in the year following an MI occur within 90-days, demonstrating that reductions in MI burden could be achieved by further targeted intervention in the early period following an MI. |
| first_indexed | 2024-03-13T10:18:23Z |
| format | Article |
| id | doaj.art-01da33e4fb0e4e769c637d6b705b8e5a |
| institution | Directory Open Access Journal |
| issn | 2772-4875 |
| language | English |
| last_indexed | 2024-03-13T10:18:23Z |
| publishDate | 2023-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology. Cardiovascular Risk and Prevention |
| spelling | doaj.art-01da33e4fb0e4e769c637d6b705b8e5a2023-05-21T04:36:06ZengElsevierInternational Journal of Cardiology. Cardiovascular Risk and Prevention2772-48752023-06-0117200185Risk of early recurrence and mortality in high-risk myocardial infarction patients: A population-based linked data studyLee Nedkoff0Tom Briffa1Kevin Murray2James Gaw3Andrea Yates4Frank M. Sanfilippo5Stephen J. Nicholls6The University of Western Australia, M431, 35 Stirling Hwy, Crawley, WA, 6009, Australia; Corresponding author. School of Population and Global Health, The University of Western Australia, M431, 35 Stirling Hwy, Crawley, Western, 6009, Australia.The University of Western Australia, M431, 35 Stirling Hwy, Crawley, WA, 6009, AustraliaThe University of Western Australia, M431, 35 Stirling Hwy, Crawley, WA, 6009, AustraliaCSL Behring, 189 – 209 Camp Road, Broadmeadows, Victoria, 3047, AustraliaCSL Behring, 189 – 209 Camp Road, Broadmeadows, Victoria, 3047, AustraliaThe University of Western Australia, M431, 35 Stirling Hwy, Crawley, WA, 6009, AustraliaVictorian Heart Institute, Monash University, Wellington Rd, Clayton, VIC, 3800, AustraliaBackground: Survival during the early period following myocardial infarction (MI) has significantly improved although there are limited data on cardiovascular recurrence during this period. Methods: We identified all emergency hospitalisations for MI from November 1, 2011 to October 31, 2016 in Western Australia from a linked hospitalisation/mortality dataset. Patients were included if they survived >3 days, had no acute kidney injury, and had ≥1 of: ≥65 years, prior MI, diabetes or peripheral arterial disease. Outcomes were major adverse cardiovascular events (MACE, a composite of CVD death, recurrent MI or stroke), cardiovascular disease (CVD) death, all-cause mortality, recurrent MI and stroke. Cumulative risks at 90-days and 1-year were estimated from Kaplan-Meier analyses and predictors of each outcome from multivariable Cox regression models. Results: There were 8024 high-risk MI patients identified (males 61.8%). Median age was 73.7 years (IQR 66.3–82.2). Half of the risk of MACE occurred in the first 90-days post-MI (6.6% vs 12.6% at 1-year) and was underpinned by risk of recurrent MI. Risk was generally higher in women than men (MACE: 6.0% males, 7.7% females, p = 0.0025; CVD mortality: 1.7% males, 3.7% females; all-cause mortality: 2.8% males, 5.6% females, p < 0.0001). Independent predictors of 90-day MACE were increasing age, heart failure history, hypertension and prior stroke. Female sex was not associated with a higher rate of any of the outcomes after multivariable adjustment. Conclusion: Half of cardiovascular events in the year following an MI occur within 90-days, demonstrating that reductions in MI burden could be achieved by further targeted intervention in the early period following an MI.http://www.sciencedirect.com/science/article/pii/S2772487523000181Myocardial infarctionMortalityRecurrenceMedical record linkage |
| spellingShingle | Lee Nedkoff Tom Briffa Kevin Murray James Gaw Andrea Yates Frank M. Sanfilippo Stephen J. Nicholls Risk of early recurrence and mortality in high-risk myocardial infarction patients: A population-based linked data study International Journal of Cardiology. Cardiovascular Risk and Prevention Myocardial infarction Mortality Recurrence Medical record linkage |
| title | Risk of early recurrence and mortality in high-risk myocardial infarction patients: A population-based linked data study |
| title_full | Risk of early recurrence and mortality in high-risk myocardial infarction patients: A population-based linked data study |
| title_fullStr | Risk of early recurrence and mortality in high-risk myocardial infarction patients: A population-based linked data study |
| title_full_unstemmed | Risk of early recurrence and mortality in high-risk myocardial infarction patients: A population-based linked data study |
| title_short | Risk of early recurrence and mortality in high-risk myocardial infarction patients: A population-based linked data study |
| title_sort | risk of early recurrence and mortality in high risk myocardial infarction patients a population based linked data study |
| topic | Myocardial infarction Mortality Recurrence Medical record linkage |
| url | http://www.sciencedirect.com/science/article/pii/S2772487523000181 |
| work_keys_str_mv | AT leenedkoff riskofearlyrecurrenceandmortalityinhighriskmyocardialinfarctionpatientsapopulationbasedlinkeddatastudy AT tombriffa riskofearlyrecurrenceandmortalityinhighriskmyocardialinfarctionpatientsapopulationbasedlinkeddatastudy AT kevinmurray riskofearlyrecurrenceandmortalityinhighriskmyocardialinfarctionpatientsapopulationbasedlinkeddatastudy AT jamesgaw riskofearlyrecurrenceandmortalityinhighriskmyocardialinfarctionpatientsapopulationbasedlinkeddatastudy AT andreayates riskofearlyrecurrenceandmortalityinhighriskmyocardialinfarctionpatientsapopulationbasedlinkeddatastudy AT frankmsanfilippo riskofearlyrecurrenceandmortalityinhighriskmyocardialinfarctionpatientsapopulationbasedlinkeddatastudy AT stephenjnicholls riskofearlyrecurrenceandmortalityinhighriskmyocardialinfarctionpatientsapopulationbasedlinkeddatastudy |