Regional Variability in Population Acute Myocardial Infarction Cumulative Incidence and Mortality Rates in Spain 1997 and 1998

Marrugat, Jaume; Elosúa, Roberto; Aldasoro, Elena; Tormo, María José; Vanaclocha, Hermelinda; Segura, Antonio; Fiol, Miquel; Moreno-Iribas, Concepción; Pérez, Glória; Arteagoitia, José M.; Cirera, Lluís; Cabadés, Adolfo; Vega, Gema; Ayestarán, José I.; García, Vega; Hurtado-de-Saracho, Iraida; García, José; Zurriaga, Óscar; Muñiz, Javier; Sala, Joan

doi:10.1023/b:ejep.0000040531.77638.17

Cited by 78 publications

(40 citation statements)

References 20 publications

(24 reference statements)

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“…[14][15][16][17][18][19][20] Furthermore, AF is an important disease entity which is directly related to recurrent systemic thromboembolic events, especially cerebral infarction, HF, and bleeding events provoked by longterm antiplatelet agent or anticoagulant prescription, especially in elderly populations. 19) About 30% of strokes in patients older than 70 years originate purely from AF.…”

Section: Discussionmentioning

confidence: 99%

Atrial Fibrillation on Admission Is Related With Higher Mortality in ST-Segment Elevation Myocardial Infarction Patients

et al. 2017

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SummaryThe prognostic significance of atrial fibrillation (AF) on mortality in ST-segment elevation myocardial infarction (STEMI) patients is not clearly understood. To elucidate the clinical significance of AF on mortality for 1 year in STEMI patients, we retrospectively analyzed the Korea Acute Myocardial Infarction Registry (KAMIR) database, which spans January 2008 to September 2010 and includes 14,329 patients with acute myocardial infarction. We selected 5,556 patients with marked ECG rhythm (NSR, normal sinus rhythm or AF) on emergency room arrival, < 12 hours of symptom onset, and who underwent primary percutaneous coronary intervention (PCI) within 90 minutes of arriving at the hospital. Patients who had been followed-up for at least for 1 year were analyzed (2,636 of NSR, 119 of AF). At enrollment, AF patients were older (70.7 versus 65.5 years, P < 0.001) and had lower systolic blood pressure (120.6 versus 125.9 mmHg, P = 0.050), a higher heart rate (80.4 versus 75.6/minute, P = 0.009), and a higher rate of Killip III, IV (25.0 versus 14.2%, P = 0.002). Patients with AF showed clearly higher all-cause mortality (22.7 versus 9.5%, HR 2.51, 95%CI 1.68~3.76, P < 0.001) and cardiac death rate (17.7 versus 7.5%, HR 2.49, 95%CI 1.59~3.90, P < 0.001) at 1 year after admission compared patients with NSR. AF induced significantly higher all-cause mortality and cardiac mortality rate in STEMI patients who were appropriately revascularized with primary PCI compared to NSR at 1 year. (Int Heart J 2017; 58: 486-494) Key words: Major adverse cardiac event, Target lesion revascularization, Normal sinus rhythm T he general prevalence of atrial fibrillation (AF) in developed countries is approximately 1.5~2%, and the average age of AF patients is continuously rising and is now between 75 and 85 years old.1,2) This arrhythmia is directly associated with a 5-fold risk of stroke, a 3-fold incidence of congestive heart failure (CHF), and higher mortality.3) The prevalence of AF is higher in diverse medical comorbid conditions such as hypertension, thyrotoxicosis, CHF, ischemic heart disease, left ventricular hypertrophy, and valvular heart diseases. In HF particularly, the prevalence of AF has been reported to range from 15 to 50% depending on age and the duration of underlying medical or cardiologic abnormalities. [4][5][6] Lifelong or temporal oral anticoagulation was needed by 5~7% of patients who underwent percutaneous coronary intervention (PCI) with a stent, and most of them were patients with AF. 7) AF patients undergoing PCI usually have more major adverse cardiac events compared to patients with normal sinus rhythm (NSR).8) The ARIAM registry showed higher inhospital mortality in new onset AF compared to NSR or previously existing AF in acute coronary syndrome (ACS), 9) and new onset AF was one of the important predictors of mortality, and non-coronary artery bypass graft (CABG) related major bleeding in ST-segment elevation myocardial infarction (STE-MI) underwent primary PCI in HORIZON-AMI study.10) The Denmark...

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Section: Discussionmentioning

confidence: 99%

Atrial Fibrillation on Admission Is Related With Higher Mortality in ST-Segment Elevation Myocardial Infarction Patients

et al. 2017

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“…[13][14][15][16][17][18][19][20][21][22][23][24] However, most of these studies focused on specific regions of Spain or covered incident cases from the 1990s, before troponin analysis was routinely used in the diagnosis of acute myocardial infarction. Because of these limitations, we decided to draw on the information in the Spanish Registry of Hospital Discharges (Minimum Basic Data Set), 25 which has been used in several studies on acute myocardial infarction.…”

Section: Acute Coronary Syndromementioning

confidence: 99%

Disability-adjusted Life Years Lost to Ischemic Heart Disease in Spain

Larrea-Baz

Morant-Ginestar

Catalá-López

et al. 2015

Revista Española de Cardiología (English Edition)

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“…The recalibrated risk function provided estimates that better matched but still slightly overestimated the projected number of events, except for a large overestimation in women aged over 65. A possible explanation is the fact that the Swiss case-fatality rate used to compute the number of cases was only 12%, which is very low compared to the literature [43,44] and might have artificially inflated the number of events. Indeed, increasing case-fatality rates to 25%, a more reasonable [43] estimate, led to more consistent results (Table 3), while increasing case-fatality rates to 44% as reported by others [44] led to an overestimation of the number of events.…”

Section: Discussionmentioning

confidence: 98%

“…A possible explanation is the fact that the Swiss case-fatality rate used to compute the number of cases was only 12%, which is very low compared to the literature [43,44] and might have artificially inflated the number of events. Indeed, increasing case-fatality rates to 25%, a more reasonable [43] estimate, led to more consistent results (Table 3), while increasing case-fatality rates to 44% as reported by others [44] led to an overestimation of the number of events. Still, sensitivity analysis showed that this overestimation was relatively small within a reasonable range of mortality and case-fatality rates, as compared to the original Framingham function.…”

Section: Discussionmentioning

confidence: 98%

Predictive accuracy of original and recalibrated Framingham risk score in the Swiss population

Marques‐Vidal

Rodondi

Bochud

et al. 2009

International Journal of Cardiology

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Regional Variability in Population Acute Myocardial Infarction Cumulative Incidence and Mortality Rates in Spain 1997 and 1998

Abstract: MI cumulative incidence and mortality rates are low compared with other industrialized countries but, vary considerably among regions in a Mediterranean country like Spain.

Cited by 78 publications

References 20 publications

Atrial Fibrillation on Admission Is Related With Higher Mortality in ST-Segment Elevation Myocardial Infarction Patients

Atrial Fibrillation on Admission Is Related With Higher Mortality in ST-Segment Elevation Myocardial Infarction Patients

Disability-adjusted Life Years Lost to Ischemic Heart Disease in Spain

Predictive accuracy of original and recalibrated Framingham risk score in the Swiss population

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