Fifteen-year mortality and cardiac, thrombotic, and bleeding events in survivors of ST-elevation myocardial infarction

Kensuke Takagi, Akihito Tanaka, Itsuro Morishima, Yasuhiro Morita, Naoki Yoshioka, Ruka Yoshida, Yasunori Kanzaki, Naoki Watanabe, Ryota Yamauchi, Shotaro Komeyama, Hiroki Sugiyama, Kazuki Shimojo, Takuro Imaoka, Gaku Sakamoto, Takuma Ohi, Hiroki Goto, Hideki Ishii, Toyoaki Murohara

研究成果: Article査読

抄録

Background: Although short-term mortality in ST-elevation myocardial infarction (STEMI) has improved, data is limited regarding very long-term mortality and concomitant clinical events in STEMI survivors who undergo primary percutaneous coronary intervention (p-PCI). This study aimed to evaluate these parameters at 15 years and to determine the predictors of 15-year mortality in these patients. Methods: The study endpoints were all-cause mortality and cardiac mortality at 15 years. Independent predictors of all-cause mortality were also analyzed. Furthermore, each thrombotic and bleeding event was evaluated. Results: Between January 2004 and December 2006, 260 STEMI survivors who underwent p-PCI (median follow-up period: 3970 days) were evaluated from the Ogaki Municipal hospital registry. The rates of all-cause mortality (cardiac mortality) at 5, 10, and 15 years were 12.1% (4.9%), 23.4% (9.5%), and 34.9% (12.4%), respectively. The cumulative incidences of recurrent myocardial infarction, target vessel revascularization, ischemic stroke, hemorrhagic bleeding, and gastric bleeding at 15 years were 11.3%, 43.6%, 14.3%, 6.9%, and 10.9%, respectively. Cox regression analysis showed that age ≥ 75 years [adjusted hazard ratio (aHR), 7.074, p < 0.001], chronic kidney disease (aHR, 2.320, p = 0.001), left ventricular ejection fraction <40% (aHR, 2.930, p = 0.001), Killip class ≥II at admission (aHR, 2.639, p = 0.003), untreated chronic total occlusion (aHR, 2.090, p = 0.042), and final TIMI grade ≤ 2 (aHR, 1.736, p = 0.048) were independent predictors of all-cause mortality. Conclusion: This study demonstrated that all-cause and cardiac mortality at 15 years were 34.9% and 12.4%, respectively, in all-comers STEMI survivors after p-PCI, indicating that STEMI survivors might have a benign prognosis.

本文言語English
ジャーナルCardiovascular Revascularization Medicine
DOI
出版ステータスAccepted/In press - 2021
外部発表はい

All Science Journal Classification (ASJC) codes

  • 循環器および心血管医学

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