Long-term outcomes in patients with type 1 and type 2 myocardial infarction (data from a single-center register study)

Abstract

Aim: To study the annual outcomes of patients with a confirmed diagnosis of myocardial infarction (MI), depending on its type.Material and Methods. Of the 1,325 hospitalized patients, 1,293 (97.5%) were diagnosed with acute coronary syndrome; the rest had extra-cardiac causes of chest pain. Follow-up included examinations of patients in the hospital and interviewing by phone or email in 12 months after discharge. All patients with MI were tested for the presence of personality type D. After 12 months of follow-up, the total number of patients diagnosed with MI was 255 (92.1%) patients [180 (70.5%) patients with MI1, 75 (29.5%) patients with MI2].Results. After 12 months of follow-up, in the general group of patients complications developed in 53 (20.7%) patients (27 (15.0%) patients in the IM1 group and 26 (34.6%) patients in the IM2 group). Overall mortality and the frequency of repeat- ed hospitalizations for heart failure were higher in MI2 compared to MI1 [8 (10.6%) vs. 2 (1.1%) (p = 0.001) and 9 (12.0%) vs. 8 (4.4%) (p = 0.03), respectively]. The main predictors of adverse events in patients with MI2 were: obesity, p = 0.005; diabetes mellitus, p = 0.006; two-vessel lesion, p = 0.001; three-vessel lesion, р = 0.001; low adherence to drug therapy (< 6 points) on the Morisky-Green scale, p = 0.007; personality type D, p = 0.040. In patients with MI1, the main predictors of adverse events were: obesity, p = 0.019; male, p = 0.009. There were no statistically significant differences in both groups in the frequency of mortality from MI, the development of recurrent MI, as well as complications such as subacute/late stent thrombosis and restenosis in the stent.Conclusion. In patients with MI2, compared with MI1, after 12 months of follow-up the indicators of total mortality (10.6% vs. 1.1%) and repeated hospitalizations due to decompensation of heart failure (12% vs. 4.4%) are higher.