ПЕРВИЧНЫЙ И ПОВТОРНЫЙ ИНФАРКТ МИОКАРДА: РАЗЛИЧИЯ В ОТДАЛЕННОЙ ВЫЖИВАЕМОСТИ ПАЦИЕНТОВ

Abstract

Purpose. To analyze the long-term survival of patients with myocardial infarction (MI), according to its type (primary or recurrent MI), age and gender. Materials and methods. 791 patients with MI admitted to the Kemerovo Cardiology Dispensary in 2006 were included in the study. The follow-up period was 8,5 years. The Kaplan-Meier analysis was performed to estimate the survival rates. A p value of 0,05 is considered statistically significant. The odds ratio (OR) with the 95 % confidence interval was calculated. Results. A total of 791 patients, 565 (71,4 %) of whom were present with primary and 226 (28,6 %) with recurrent MI were included in the study. Overall, 446 (56,3 %) patients died during the follow-up period. The cause of death was known in 365 patients (81,8 %). The major cause of death was circulatory system diseases (88,2 %). The survival rate for seven years in patients with primary MI was 49,8 % and in patients with recurrent MI – 31,5 % (p=0,00001, OR=2,2 [1,5, 3,0]). The risk of death was greatest in the first year after any type of MI; however, the risk of death after recurrent MI increased 2-fold, compared with primary MI. The long-term survival was lower in females than in males (p=0,0065, OR=1,42 [1,07; 1,90]). In case of primary IM, this parameter was also worse in females than in males (p=0,002, OR=1,6 [1,1; 2,2]). However, there were no gender-related differences in the long-term survival after recurrent MI (p=0,33, OR=1,1 [0,6; 1,9]). Conclusion. The results of the present study suggest a higher risk of death and poor long-term survival in patients with recurrent myocardial infarction compared to patients with primary MI.