Long-term Survival in a Spanish Population With Stable Ischemic Heart Disease. The CICCOR Registry
José Javier Sánchez Fernández1, Martín Ruiz Ortiz1, Cristina Ogayar Luque1
1Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain.
Insights
Patients with stable ischemic heart disease (SIHD) face higher mortality rates than the general population. Key predictors of death include age, diabetes, resting heart rate, atrial fibrillation, ECG changes, and active smoking.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Long-term prognosis data for stable ischemic heart disease (SIHD) is limited.
- Understanding long-term survival and mortality predictors in SIHD is crucial for patient management.
Purpose of the Study:
- To analyze the long-term survival of patients diagnosed with SIHD.
- To identify independent predictors of all-cause and cardiovascular mortality in this patient group.
Main Methods:
- A prospective cohort study involving 1268 outpatients with SIHD.
- Data collected from January 2000 to February 2004, with follow-up extending up to 17 years.
- Comparison of mortality rates with the general Spanish population, adjusted for age, sex, and year.
Main Results:
- Over a median follow-up of 11 years, 50% of patients died.
- Independent predictors of all-cause mortality included older age, diabetes, elevated resting heart rate, atrial fibrillation, specific electrocardiographic changes, and active smoking.
- Both all-cause and cardiovascular mortality rates were significantly higher in the SIHD cohort compared to the general Spanish population.
Conclusions:
- Patients with SIHD exhibit a higher mortality rate compared to the general population.
- Several clinical factors, including age, diabetes, heart rate, atrial fibrillation, ECG findings, and smoking status, can identify individuals at increased risk of mortality.
Introduction And Objectives:
Data are lacking on the long-term prognosis of stable ischemic heart disease (SIHD). Our aim was to analyze long-term survival in patients with SIHD and to identify predictors of mortality.
Methods:
A total of 1268 outpatients with SIHD were recruited in this single-center prospective cohort study from January 2000 to February 2004. Cardiovascular and all-cause death during follow-up were registered. All-cause and cardiovascular mortality rates were compared with those in the Spanish population adjusted by age, sex, and year. Predictors of these events were investigated.
Results:
The mean age was 68±10 years and 73% of the patients were male. After a follow-up lasting up to 17 years (median 11 years), 629 (50%) patients died. Independent predictors of all-cause mortality were age (HR, 1.08; 95%CI, 1.07-1.11; P <.001), diabetes (HR, 1.36; 95%CI, 1.14-1.63; P <.001), resting heart rate (HR, 1.01; 95%CI, 1.00-1.02; P <.001), atrial fibrillation (HR, 1.61; 95%CI, 1.22-2.14; P=.001), electrocardiographic changes (HR, 1.23; 95%CI, 1.02-1.49; P=.02) and active smoking (HR, 1.85; 95%CI, 1.31-2.80; P=.001). All-cause mortality and cardiovascular mortality rates were significantly higher in the sample than in the general Spanish population (47.81/1000 patients/y vs 36.29/1000 patients/y (standardized mortality rate, 1.31; 95%CI, 1.21-1.41) and 15.25/1000 patients/y vs 6.94/1000 patients/y (standardized mortality rate, 2.19; 95%CI, 1.88-2.50, respectively).
Conclusions:
The mortality rate was higher in this sample of patients with SIHD than in the general population. Several clinical variables can identify patients at higher risk of death during follow-up.
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