Abstract
BackgroundMyocardial infarction (MI) is associated with high morbidity and mortality, particularly in the first 12 months post-event. Interventions such as dual antiplatelet therapy can reduce the risk of major adverse cardiovascular events (MACE), but the duration of the high-risk time interval and the optimal prescription time frame for these interventions remains unknown.Design, setting, participants, and measurementsWe performed a retrospective cohort study using data from medical services and hospitalizations in Manitoba, Canada for patients admitted with a MI between April 2006 and March 2010, and followed until Nov 30, 2014. We used survival analysis to determine the cumulative incidence of death, subsequent MI, or stroke, and used Cox proportional hazards models to assess factors associated with these endpoints.ResultsThere were 8,493 patients in Manitoba admitted to hospital for a MI during the study period. Of those, 6,749 (79.5%) survived for at least 1 year without a recurrent MI or stroke. In the following year, this population remained at high risk, with 372 (5.5%) of the remaining patients dying in the next twelve months (48.1% cardiovascular deaths), 244 (3.6%) having a recurrent MI, and 74 (1.1%) having a stroke. Older age, male sex, diabetes, prior stroke, prior heart failure, prior unstable angina, and absence of revascularization were associated with worse long-term prognosis.ConclusionsThe risk of MACE remains elevated among post-MI patients after the first year. Interventions to more intensively monitor, evaluate, and treat these patients should be considered beyond the first year following myocardial infarction.
Highlights
Cardiovascular (CV) disease causes one-third of deaths in Canada, more than any other illness, and is associated with a high economic burden on the health care system [1]
Myocardial infarction (MI) is associated with high morbidity and mortality, in the first 12 months post-event. Interventions such as dual antiplatelet therapy can reduce the risk of major adverse cardiovascular events (MACE), but the duration of the high-risk time interval and the optimal prescription time frame for these interventions remains unknown
The risk of MACE remains elevated among post-MI patients after the first year
Summary
Cardiovascular (CV) disease causes one-third of deaths in Canada, more than any other illness, and is associated with a high economic burden on the health care system [1]. Despite improvements in acute therapy, and better risk factor control, recurrence rates of major adverse cardiovascular events (MACE), including MI, stroke, and/or death remain high, affecting nearly 1 in 5 patients in the first year post discharge and another 1 in 5 patients over the 3 years [2,3,4]. Dual antiplatelet therapy (DAPT) is a mainstay of secondary prevention of MACE up to 1 year post-event [7]. Myocardial infarction (MI) is associated with high morbidity and mortality, in the first 12 months post-event. Interventions such as dual antiplatelet therapy can reduce the risk of major adverse cardiovascular events (MACE), but the duration of the high-risk time interval and the optimal prescription time frame for these interventions remains unknown
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
