Long-term prognosis after hospital admission for acute myocardial infarction from 1987 to 2006

Dudas, Kerstin; Lappas, Georg; Rosengren, Annika

doi:10.1016/j.ijcard.2010.10.047

Cited by 29 publications

(24 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Long-term annual mortality was around 1% with no difference between men and women, similar to our study. Accordingly, in absolute terms and consistent with prior publications from our group,1 annual mortality rates in AMI survivors younger than 55 years are estimated at about 1%. This is in contrast to older patients in Sweden, among whom annual mortality rates are about 6% for those aged 65–74 years and more than 12% among patients aged 75–84 years 1.…”

Section: Discussionsupporting

confidence: 89%

Sex-specific trends in 4-year survival in 37 276 men and women with acute myocardial infarction before the age of 55 years in Sweden, 1987–2006: a register-based cohort study

et al. 2014

View full text Add to dashboard Cite

ObjectiveTo examine sex-specific trends in 4-year mortality among young patients with first acute myocardial infarction (AMI), 1987–2006.DesignProspective cohort study.SettingSweden.ParticipantsWe identified 37 276 cases (19.4% women; age, 25–54 years) from the Swedish Inpatient Register, 1987–2006, who had survived 28 days after an AMI.Outcome measures4-year mortality from all causes and standard mortality ratio (SMR).ResultsFrom the first to last 5-year period, the absolute excess risk decreased from 1.38 to 0.50 and 1.53 to 0.59 per 100 person-years among men aged 25–44 and 45–54 years, respectively. Corresponding figures for women were a decrease from 2.26 to 1.17 and from 1.93 to 1.45 per 100 person-years, respectively. Trends for women were non-linear, decreasing to the same extent as those for men until the third period, then increasing. For the last 5-year period, the standardised mortality ratio for young survivors of AMI compared with the general population was 4.34 (95% CI 3.04 to 5.87) and 2.43 (95% CI 2.12 to 2.76) for men aged 25–44 and 45–54 years, respectively, and 13.53 (95% CI 8.36 to 19.93) and 6.42 (95% CI 5.24 to 7.73) for women, respectively. Deaths not associated with cardiovascular causes increased from 21.5% to 44.6% in men and 41.5% to 65.9% in women.ConclusionsYoung male survivors of AMI have low absolute long-term mortality rates, but these rates remain twofold to fourfold that of the general population. After favourable development until 2001, women now have higher absolute mortality than men and a 6-fold to 14-fold risk of death compared with women in the general population.

show abstract

Section: Discussionsupporting

confidence: 89%

Sex-specific trends in 4-year survival in 37 276 men and women with acute myocardial infarction before the age of 55 years in Sweden, 1987–2006: a register-based cohort study

et al. 2014

View full text Add to dashboard Cite

show abstract

“…[4][5][6][7] Since this initial classification, clinical presentation in ACS has changed somewhat, with a decrease in mortality and reduced case-death following AMI. [8][9][10] This change in clinical presentation in AMI with less severe infarctions and better clinical outcomes may be explained by new or improved treatments and interventions. [11][12][13] In addition, changes in risk factors across various populations, such as less tobacco smoking and decreasing levels of total cholesterol, may have similarly contributed to these improved outcomes.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Differences between acute myocardial infarction and unstable angina: a longitudinal cohort study reporting findings from the Register of Information and Knowledge about Swedish Heart Intensive Care Admissions (RIKS-HIA)

et al. 2013

Self Cite

View full text Add to dashboard Cite

ObjectivesThe aim of this study was to compare risk factors and comorbidities in patients with a first episode of acute coronary syndrome (ACS), being either acute myocardial infarction (AMI) or unstable angina pectoris (UAP).DesignCross-sectional and prospective.SettingThe Swedish population.ParticipantsA total of 145 346 consecutive patients aged 25–105 years included in the Swedish Register of Cardiac Intensive Care Admission (Register of Information and Knowledge about Swedish Heart Intensive Care) and admitted to hospital between 1 January 1996 and 30 June 2009 with a first episode of either AMI or UAP.Primary and secondary outcome measuresType of ACS and 1-year outcome.ResultsCompared with patients with UAP, AMI patients were more likely to be older; men; and former or current smokers; they were also more likely to have had diabetes and peripheral artery disease, but had lower rates of prior heart failure (HF) and fewer cardioprotective medications on admission. Among patients aged <65 years, 1.4% of men and 1.6% of women with UAP died within 1 year in 2003–2006 compared with 4.2% of men and 3.1% of women AMI patients (multiple-adjusted OR 3.54 (99% CI 2.29 to 5.48) in women and 2.65 (99% CI 2.11 to 3.34) in men). Corresponding proportions in patients aged ≥65 years was 7.5% in men and 7.6% in women with UAP and 21.5% in men and 17.8% in women with AMI.ConclusionsIn patients with a first-time ACS episode, male sex, slightly older age, smoking, diabetes and peripheral arterial disease (PAD), but fewer cardioprotective medications, were major determinants for presenting with AMI. Despite increasingly active treatment in AMI and more inclusive diagnostic criteria in recent years, persistently worse prognosis was observed in AMI patients.

show abstract

“…Short‐ and long‐term mortality after an acute myocardial infarction (AMI) has decreased over past decades worldwide, but some reports imply less effective reduction in women . Debates are ongoing as to whether sex‐specific differences exist in clinical course, diagnosis, and management of ischemic heart disease and the extent to which these differences can be alleviated by changes in clinical praxis …”

Section: Introductionmentioning

confidence: 99%

Trends in Gender Differences in Cardiac Care and Outcome After Acute Myocardial Infarction in Western Sweden: A Report From the Swedish Web System for Enhancement of Evidence‐Based Care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART)

Redfors

Angerås

Råmunddal

et al. 2015

JAHA

View full text Add to dashboard Cite

BackgroundCardiovascular disease is the most common cause of death for both genders. Debates are ongoing as to whether gender-specific differences in clinical course, diagnosis, and management of acute myocardial infarction (MI) exist.Methods and ResultsWe compared all men and women who were treated for acute MI at cardiac care units in Västra Götaland, Sweden, between January 1995 and October 2014 by obtaining data from the prospective SWEDEHEART (Swedish Web-System for Enhancement of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies) registry. We performed unadjusted and adjusted Cox proportional hazards and logistic regression analyses on complete case data and on imputed data sets. Overall, 48 118 patients (35.4% women) were diagnosed with acute MI. Women as a group had better age-adjusted prognosis than men, but this survival benefit was absent for younger women (aged <60 years) and for women with ST-segment elevation MI. Compared with men, younger women and women with ST-segment elevation MI were more likely to develop prehospital cardiogenic shock (adjusted odds ratio 1.67, 95% CI 1.30 to 2.16, P<0.001 and adjusted odds ratio 1.31, 95% CI 1.16 to 1.48, P<0.001) and were less likely to be prescribed evidence-based treatment at discharge (P<0.001 for β-blockers, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, statins, and P2Y12 antagonists). Differences in treatment between the genders did not decrease over the study period (P>0.1 for all treatments).ConclusionsWomen on average have better adjusted prognosis than men after acute MI; however, younger women and women with ST-segment elevation MI have disproportionately poor prognosis and are less likely to be prescribed evidence-based treatment.

show abstract

Long-term prognosis after hospital admission for acute myocardial infarction from 1987 to 2006

Cited by 29 publications

References 32 publications

Sex-specific trends in 4-year survival in 37 276 men and women with acute myocardial infarction before the age of 55 years in Sweden, 1987–2006: a register-based cohort study

Sex-specific trends in 4-year survival in 37 276 men and women with acute myocardial infarction before the age of 55 years in Sweden, 1987–2006: a register-based cohort study

Differences between acute myocardial infarction and unstable angina: a longitudinal cohort study reporting findings from the Register of Information and Knowledge about Swedish Heart Intensive Care Admissions (RIKS-HIA)

Trends in Gender Differences in Cardiac Care and Outcome After Acute Myocardial Infarction in Western Sweden: A Report From the Swedish Web System for Enhancement of Evidence‐Based Care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART)

Contact Info

Product

Resources

About