Short- and long-term cause of death in patients treated with primary PCI for STEMI
Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved..
BACKGROUND: Short-term mortality has been studied thoroughly in patients undergoing primary percutaneous coronary intervention (PCI), whereas long-term cause of death in patients with ST-segment elevation myocardial infarction (STEMI) remains unknown.
OBJECTIVES: The goal of this study was to describe the association between time and cause of death in patients with STEMI undergoing primary PCI.
METHODS: A centralized civil registration system, patient files, and public disease and death cause registries with an accurate record linkage were used to trace time and cause of death in 2,804 consecutive patients with STEMI (age 63 ± 13 years, 72% males) treated with primary PCI.
RESULTS: Patients were followed up for a median of 4.7 years. During a total of 13,447 patient-years, 717 patients died. Main causes of death within the first 30 days were cardiogenic shock and anoxic brain injury after cardiac arrest. Age, culprit vessel size and flow, and the presence of heart failure and diabetes were independent predictors of mortality. After 30 days, the annual cardiac mortality rate was <1.5%. Causes of death beyond 30 days were noncardiac in 65% of cases (mainly malignancies and pulmonary diseases). The 30-day, 1-year, and 5-year all-cause (and cardiac) mortality rates were 7.9% (7.3%), 11.4% (8.4%), and 23.3% (13.8%), respectively.
CONCLUSIONS: Patients who survive the first month after an STEMI treated with primary PCI have an excellent prognosis, with a <1.5% annual risk of successive cardiac death. Noncardiac causes are responsible for the majority of later deaths in these patients.
| Errataetall: |
CommentIn: J Am Coll Cardiol. 2014 Nov 18-25;64(20):2109-10. - PMID 25457399 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2014 |
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| Erschienen: |
2014 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:64 |
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| Enthalten in: |
Journal of the American College of Cardiology - 64(2014), 20 vom: 06. Nov., Seite 2101-8 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Pedersen, Frants [VerfasserIn] |
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| Links: |
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| Themen: |
Acute myocardial infarction |
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| Anmerkungen: |
Date Completed 06.02.2015 Date Revised 09.04.2022 published: Print-Electronic CommentIn: J Am Coll Cardiol. 2014 Nov 18-25;64(20):2109-10. - PMID 25457399 Citation Status MEDLINE |
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| doi: |
10.1016/j.jacc.2014.08.037 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM244116407 |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: J Am Coll Cardiol. 2014 Nov 18-25;64(20):2109-10. - PMID 25457399 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Short-term mortality has been studied thoroughly in patients undergoing primary percutaneous coronary intervention (PCI), whereas long-term cause of death in patients with ST-segment elevation myocardial infarction (STEMI) remains unknown | ||
| 520 | |a OBJECTIVES: The goal of this study was to describe the association between time and cause of death in patients with STEMI undergoing primary PCI | ||
| 520 | |a METHODS: A centralized civil registration system, patient files, and public disease and death cause registries with an accurate record linkage were used to trace time and cause of death in 2,804 consecutive patients with STEMI (age 63 ± 13 years, 72% males) treated with primary PCI | ||
| 520 | |a RESULTS: Patients were followed up for a median of 4.7 years. During a total of 13,447 patient-years, 717 patients died. Main causes of death within the first 30 days were cardiogenic shock and anoxic brain injury after cardiac arrest. Age, culprit vessel size and flow, and the presence of heart failure and diabetes were independent predictors of mortality. After 30 days, the annual cardiac mortality rate was <1.5%. Causes of death beyond 30 days were noncardiac in 65% of cases (mainly malignancies and pulmonary diseases). The 30-day, 1-year, and 5-year all-cause (and cardiac) mortality rates were 7.9% (7.3%), 11.4% (8.4%), and 23.3% (13.8%), respectively | ||
| 520 | |a CONCLUSIONS: Patients who survive the first month after an STEMI treated with primary PCI have an excellent prognosis, with a <1.5% annual risk of successive cardiac death. Noncardiac causes are responsible for the majority of later deaths in these patients | ||
| 650 | 4 | |a Journal Article | |
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| 650 | 4 | |a acute myocardial infarction | |
| 650 | 4 | |a cause of death | |
| 650 | 4 | |a follow-up study | |
| 650 | 4 | |a percutaneous coronary intervention | |
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| 700 | 1 | |a Kelbæk, Henning |e verfasserin |4 aut | |
| 700 | 1 | |a Wachtell, Kristian |e verfasserin |4 aut | |
| 700 | 1 | |a Helqvist, Steffen |e verfasserin |4 aut | |
| 700 | 1 | |a Kastrup, Jens |e verfasserin |4 aut | |
| 700 | 1 | |a Holmvang, Lene |e verfasserin |4 aut | |
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