Temporal Trends in Noncardiovascular Morbidity and Mortality Following Acute Myocardial Infarction
Copyright © 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved..
BACKGROUND: Due to improved management, diagnosis, and care of myocardial infarction (MI), patients may now survive long enough to increasingly develop serious noncardiovascular conditions.
OBJECTIVES: This study aimed to test this hypothesis by investigating the temporal trends in noncardiovascular morbidity and mortality following MI.
METHODS: We conducted a registry-based nationwide cohort study of all Danish patients with MI during 2000 to 2017. Outcomes were cardiovascular and noncardiovascular mortality, incident cancer, incident renal disease, and severe infectious disease.
RESULTS: From 2000 to 2017, 136,293 consecutive patients were identified (63.2% men, median age 69 years). The 1-year risk of cardiovascular mortality between 2000 to 2002 and 2015 to 2017 decreased from 18.4% to 7.6%, whereas noncardiovascular mortality decreased from 5.8% to 5.0%. This corresponded to an increase in the proportion of total 1-year mortality attributed to noncardiovascular causes from 24.1% to 39.5%. Furthermore, increases in 1-year risk of incident cancer (1.9%-2.4%), incident renal disease (1.0%-1.6%), and infectious disease (5.5%-9.1%) were observed (all P trend <0.01). In analyses standardized for changes in patient characteristics, the increased risk of cancer in 2015 to 2017 compared with 2000 to 2002 was no longer significant (standardized risk ratios for cancer: 0.99 [95% CI: 0.91-1.07]; renal disease: 1.28 [95% CI: 1.15-1.41]; infectious disease: 1.28 [95% CI: 1.23-1.34]).
CONCLUSIONS: Although cardiovascular mortality following MI improved substantially during 2000 to 2017, the risk of noncardiovascular morbidity increased. Moreover, noncardiovascular causes constitute an increasing proportion of post-MI mortality. These findings suggest that further attention on noncardiovascular outcomes is warranted in guidelines and clinical practice and should be considered in the design of future clinical trials.
| Errataetall: |
CommentIn: J Am Coll Cardiol. 2023 Sep 5;82(10):982-984. - PMID 37648356 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:82 |
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| Enthalten in: |
Journal of the American College of Cardiology - 82(2023), 10 vom: 05. Sept., Seite 971-981 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Christensen, Daniel Mølager [VerfasserIn] |
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| Links: |
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Journal Article |
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| Anmerkungen: |
Date Completed 01.09.2023 Date Revised 07.09.2023 published: Print CommentIn: J Am Coll Cardiol. 2023 Sep 5;82(10):982-984. - PMID 37648356 Citation Status MEDLINE |
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| doi: |
10.1016/j.jacc.2023.06.024 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM361462182 |
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| 100 | 1 | |a Christensen, Daniel Mølager |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Temporal Trends in Noncardiovascular Morbidity and Mortality Following Acute Myocardial Infarction |
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| 500 | |a Date Completed 01.09.2023 | ||
| 500 | |a Date Revised 07.09.2023 | ||
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| 500 | |a CommentIn: J Am Coll Cardiol. 2023 Sep 5;82(10):982-984. - PMID 37648356 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Due to improved management, diagnosis, and care of myocardial infarction (MI), patients may now survive long enough to increasingly develop serious noncardiovascular conditions | ||
| 520 | |a OBJECTIVES: This study aimed to test this hypothesis by investigating the temporal trends in noncardiovascular morbidity and mortality following MI | ||
| 520 | |a METHODS: We conducted a registry-based nationwide cohort study of all Danish patients with MI during 2000 to 2017. Outcomes were cardiovascular and noncardiovascular mortality, incident cancer, incident renal disease, and severe infectious disease | ||
| 520 | |a RESULTS: From 2000 to 2017, 136,293 consecutive patients were identified (63.2% men, median age 69 years). The 1-year risk of cardiovascular mortality between 2000 to 2002 and 2015 to 2017 decreased from 18.4% to 7.6%, whereas noncardiovascular mortality decreased from 5.8% to 5.0%. This corresponded to an increase in the proportion of total 1-year mortality attributed to noncardiovascular causes from 24.1% to 39.5%. Furthermore, increases in 1-year risk of incident cancer (1.9%-2.4%), incident renal disease (1.0%-1.6%), and infectious disease (5.5%-9.1%) were observed (all P trend <0.01). In analyses standardized for changes in patient characteristics, the increased risk of cancer in 2015 to 2017 compared with 2000 to 2002 was no longer significant (standardized risk ratios for cancer: 0.99 [95% CI: 0.91-1.07]; renal disease: 1.28 [95% CI: 1.15-1.41]; infectious disease: 1.28 [95% CI: 1.23-1.34]) | ||
| 520 | |a CONCLUSIONS: Although cardiovascular mortality following MI improved substantially during 2000 to 2017, the risk of noncardiovascular morbidity increased. Moreover, noncardiovascular causes constitute an increasing proportion of post-MI mortality. These findings suggest that further attention on noncardiovascular outcomes is warranted in guidelines and clinical practice and should be considered in the design of future clinical trials | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a mortality | |
| 650 | 4 | |a noncardiovascular | |
| 650 | 4 | |a outcomes | |
| 650 | 4 | |a registry | |
| 650 | 4 | |a trends | |
| 700 | 1 | |a Strange, Jarl Emanuel |e verfasserin |4 aut | |
| 700 | 1 | |a El-Chouli, Mohamad |e verfasserin |4 aut | |
| 700 | 1 | |a Falkentoft, Alexander Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Malmborg, Morten |e verfasserin |4 aut | |
| 700 | 1 | |a Nouhravesh, Nina |e verfasserin |4 aut | |
| 700 | 1 | |a Gislason, Gunnar |e verfasserin |4 aut | |
| 700 | 1 | |a Schou, Morten |e verfasserin |4 aut | |
| 700 | 1 | |a Torp-Pedersen, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Sehested, Thomas S G |e verfasserin |4 aut | |
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