Causes of Death in Patients With Acute and Chronic Myocardial Injury

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Erik Kadesjö1, Andreas Roos1, Anwar J Siddiqui1

  • 1Department of Medicine, Karolinska Institutet, Solna, Sweden; Functional Area of Emergency Medicine, Karolinska University Hospital, Huddinge, Sweden.

The American Journal of Medicine
|December 3, 2019
PubMed

Insights

Patients with myocardial injury, particularly type 1 myocardial infarction and nonischemic injury, face a significantly higher risk of cardiovascular death. Further investigation into nonischemic myocardial injury is crucial.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Pathophysiology

Background:

  • Limited data exists on mortality causes in myocardial injury patients.
  • Understanding causes of death is vital for patient management and prognosis.

Purpose of the Study:

  • To investigate and compare causes of death across different types of myocardial injury.
  • To identify specific injury types associated with increased mortality risk.

Main Methods:

  • A cohort of 22,589 patients was analyzed, identifying 3853 with myocardial injury.
  • Patients were categorized into type 1 myocardial infarction, type 2 myocardial infarction, and nonischemic acute/chronic myocardial injury.
  • Causes of death were analyzed in 1466 deceased patients, comparing them to a control group without myocardial injury.

Main Results:

  • Cardiovascular death proportion was higher in all myocardial injury groups compared to controls (25% vs. 39-48%).
  • Type 1 myocardial infarction, acute, and chronic myocardial injury showed significantly higher risks for cardiovascular death (ORs 1.77, 1.40, 1.36 respectively).
  • Adjusted rates for cardiovascular death were similar across myocardial injury categories.

Conclusions:

  • Type 1 myocardial infarction and nonischemic myocardial injury (acute/chronic) are associated with similar, elevated risks of cardiovascular death.
  • These findings highlight the need for further research into nonischemic myocardial injury and type 2 myocardial infarction.
  • Investigating patients presenting with non-traditional myocardial injury is essential for improved clinical outcomes.
Abstract

Keywords:
Cardiac biomarkerChest painMyocardial infarctionPrognosisTroponin

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