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Mortality in Patients with Acute Coronary Syndrome-A Prospective 5-Year Follow-Up Study
Thuy Mi Nguyen1,2,3, Daniela Melichova1,2,3, Eivind W Aabel2,3
1Department of Cardiology, Hospital of Southern of Norway, 4604 Kristiansand, Norway.
Journal of Clinical Medicine
|October 28, 2023
Summary
Mortality for non-ST-elevation myocardial infarction (NSTEMI) remained unchanged over a decade. However, ST-elevation myocardial infarction (STEMI) patients saw significantly reduced mortality, linked to faster coronary angiography times.
Area of Science:
- Cardiology
- Clinical Research
- Public Health
Background:
- Contemporary data on long-term outcomes after myocardial infarction (MI) revascularization are limited.
- Comparing outcomes between non-ST-elevation MI (NSTEMI) and ST-elevation MI (STEMI) over time is crucial for evaluating treatment advancements.
- Southern Norway provides a specific regional context for this comparative analysis.
Purpose of the Study:
- To compare long-term outcomes, specifically all-cause mortality, in NSTEMI and STEMI patients.
- To evaluate changes in mortality and time to coronary angiography between two distinct treatment periods (2004-2009 and 2014-2015).
- To assess the impact of treatment evolution on acute myocardial infarction (AMI) patient outcomes over a decade.
Main Methods:
- Prospective follow-up study design.
- Inclusion of consecutive NSTEMI and STEMI patients from two time periods: 2004-2009 and 2014-2015.
- 5-year follow-up for primary outcome of all-cause mortality at 1 and 5 years post-MI.
Main Results:
- Mortality rates for NSTEMI patients remained stable: 1-year (3.5% vs. 4.9%, p=0.50) and 5-year (11.4% vs. 14.6%, p=0.40).
- STEMI patients showed significantly reduced 1-year mortality (1.3% vs. 11.1%, p<0.001) and 5-year mortality (7.0% vs. 22.2%, p=0.004) in the later period.
- Time to coronary angiography improved significantly for STEMI patients (2.8h vs. 21.7h, p<0.001), while it remained unchanged for NSTEMI patients (28.2h vs. 30.3h, p=0.20).
Conclusions:
- Despite advancements in acute myocardial infarction (AMI) treatment over a decade, mortality in NSTEMI patients has not improved.
- Significant improvements in long-term outcomes for STEMI patients were observed, correlating with reduced time to coronary angiography.
- The findings highlight a disparity in treatment outcome evolution between NSTEMI and STEMI, underscoring the need for continued research and optimized care pathways for NSTEMI.
Keywords:
ST-segment elevation myocardial infarctionacute myocardial infarctionlong-term follow upmortalitynon-ST-segment elevation myocardial infarctionMore Related Videos
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