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Published on: January 28, 2020
Predictors of all-cause 1-year mortality in myocardial infarction patients
1Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230036, PR China.
Insights
Myocardial infarction (MI) survivors face higher mortality risks. Left ventricular ejection fraction (LVEF) dysfunction and pump failure are key independent predictors of 1-year mortality after MI.
Area of Science:
- Cardiology
- Clinical Medicine
- Morbidity and Mortality Studies
Background:
- Myocardial infarction (MI) survivors have an elevated risk of mortality in the first year post-event compared to the general population.
- Identifying early predictors of mortality is crucial for improving patient outcomes and guiding clinical management.
Purpose of the Study:
- To investigate the association between clinical variables during index admission and 1-year all-cause mortality in MI survivors.
- To identify independent predictors of mortality following percutaneous coronary intervention for MI.
Main Methods:
- A cohort of 296 MI patients undergoing percutaneous coronary intervention was studied.
- Statistical analyses included chi-square and t tests for univariate associations.
- Logistic regression was used for multivariable analysis to adjust for baseline characteristics.
Main Results:
- Patients deceased within 1 year had higher mean age, diabetes prevalence, and heart rate.
- Univariate analysis linked mortality to pump failure, bleeding complications, Gensini score, and reduced left ventricular ejection fraction (LVEF).
- Independent predictors of 1-year mortality were pump failure and reduced LVEF after adjustment.
Conclusions:
- Left ventricular ejection fraction (LVEF) dysfunction and pump failure are significant independent predictors of 1-year all-cause mortality post-MI.
- Coronary artery disease severity and bleeding complications were not independent predictors in this cohort.
- Age, diabetes, and elevated heart rate may serve as indicators for increased mortality risk.
Abstract:
Compared with the general population, myocardial infarction (MI) survivors have a higher risk of mortality in the first year after the index event.The aim of this study was to determine the associations between variables obtained during the index admission and 1-year all-cause mortality on follow-up.A cohort of 296 patients was enrolled in the study, with a median age of 63.8 ± 12.68 years. All patients received a coronary angiography and stent implantation by percutaneous coronary intervention. Each variable was tested for association with all-cause mortality, using chi-square tests for categorical and binary variables and t tests for continuous variables. The relative prognostic power of each significant variable was further evaluated by logistic regression before and after adjustment for differences in baseline characteristics.Patients who were deceased after 1-year of MI had significantly higher mean age, increased prevalence of diabetes, and elevated heart rate as compared to those who were surviving. Univariate analysis indicated that patient mortality within 1-year of MI was strongly correlated with higher rates of pump failure on admission (P < .0001), bleeding complications (P = .02), the severity of coronary artery disease measured by Gensini score (P = .04), and decreased left ventricular ejection fraction (LVEF) (P < .0001). After adjustment of baseline variables, only pump failure (P = .006) and reduced LVEF (P < .0001) were independently associated with 1-year mortality.Our study shows that LVEF dysfunction and pump failure are independent predictors of 1-year all-cause post-MI mortality, while the severity of coronary artery disease and bleeding did not qualify as independent predictors. Also, age, history of diabetes, and elevated heart rate may be used as markers for increased mortality rates.
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