Short and Long-Term Survival Rates Following Myocardial Infarction and Its Predictive Factors: A Study Using National
Samaneh Mozaffarian1, Korosh Etemad2, Mohammad Aghaali1
1School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Insights
Predicting survival after myocardial infarction (MI) is crucial for patient outcomes. This study identified key risk factors like hypertension and diabetes, alongside protective factors such as hyperlipidemia, for short and long-term survival post-MI.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Coronary artery disease, including myocardial infarction (MI), is a leading global cause of mortality.
- Iran faces a significant burden from cardiovascular diseases, necessitating localized survival prediction models.
Purpose of the Study:
- To predict short-term and long-term survival rates following a first myocardial infarction (MI).
- To identify key clinical and demographic factors influencing survival after MI in the Iranian population.
Main Methods:
- Retrospective cohort study utilizing data from the Myocardial Infarction Registry of Iran (2013-2014).
- Analysis of variables including medical history, lifestyle factors, MI characteristics, and complications.
- Survival analysis performed using Kaplan-Meier, log-rank tests, and Cox proportional hazards models.
Main Results:
- A total of 21,181 patients with first MI were analyzed; 11.7% died within one year.
- One-year survival rate was estimated at 88%.
- Significant predictors of increased mortality included prior chronic heart disease, hypertension, and diabetes. Hyperlipidemia and inferior wall MI were associated with decreased mortality risk.
Conclusions:
- The study provides critical insights into factors affecting survival after myocardial infarction.
- Findings can inform healthcare policy and clinical decision-making for managing MI patients in Iran.
- Identifying high-risk individuals can facilitate targeted interventions to improve post-MI outcomes.
Abstract:
Background: Coronary artery disease is the most common cause of death worldwide as well as in Iran. The present study was designed to predict short and long-term survival rates after the first episode of myocardial infarction (MI). Methods: The current research is a retrospective cohort study. The data were collected from the Myocardial Infarction Registry of Iran in a 12-month period leading to March 20, 2014. The variables analyzed included smoking status, past medical history of chronic heart disease, hypertension, diabetes, hyperlipidemia, signs and symptoms during an attack, post-MI complications during hospitalization, the occurrence of arrhythmias, the location of MI, and the place of residence. Survival rates and predictive factors were estimated by the Kaplan-Meier method, the log-rank test, and the Cox model. Results: Totally, 21 181 patients with the first MI were studied. There were 15 328 men (72.4%), and the mean age of the study population was 62.10±13.42 years. During a 1-year period following MI, 2479 patients (11.7%) died. Overall, the survival rates at 28 days, 6 months, and 1 year were estimated to be 0.95 (95% CI: 0.95 to 0.96), 0.90 (95% CI: 0.90 to 0.91), and 0.88 (95% CI: 0.88 to 0.89). After the confounding factors were controlled, history of chronic heart disease (p<0.001), hypertension (p<0.001), and diabetes (p<0.001) had a significant relationship with an increased risk of death and history of hyperlipidemia (p<0.001) and inferior wall MI (p<0.001) had a significant relationship with a decreased risk of death. Conclusion: The results of this study provide evidence for health policy-makers and physicians on the link between MI and its predictive factors.
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