Factors Associated With Mortality During the First Year Post Infarction: Survival Analysis of Patients With Acute
Anderson Bermon1, Maricel Licht-Ardila2, Fabián Manrique-Hernández3
1Epidemiology, Escuela de Graduados, Universidad CES, Medellin, COL.
Insights
Post-acute myocardial infarction (AMI) patients with diabetes and renal insufficiency face higher mortality risks. Comprehensive management is crucial for improving survival in the first year after AMI.
Area of Science:
- Cardiology
- Public Health
- Clinical Research
Background:
- Cardiovascular diseases are a leading global cause of death.
- Risk factors and social determinants significantly impact mortality post-acute myocardial infarction (AMI).
Purpose of the Study:
- To identify factors associated with one-year mortality in patients following an acute myocardial infarction (AMI).
Main Methods:
- Prospective cohort study of 1873 adult patients with type 1 AMI.
- Data collected included intrahospital and outpatient information.
- Kaplan-Meier survival analysis and Cox regression were employed to evaluate mortality predictors.
Main Results:
- The one-year mortality rate was 9.4%, with an estimated survival probability of 88.61%.
- Key mortality predictors identified via Cox analysis included advanced age, diabetes, and renal insufficiency.
- The predictive model demonstrated strong capacity for identifying at-risk patients.
Conclusions:
- Diabetes and chronic kidney disease are significant predictors of one-year mortality post-AMI.
- Comprehensive management strategies are essential for AMI patients with these risk factors.
Introduction:
Cardiovascular diseases account for over 80% of global deaths. Risk factors and social determinants influence mortality in patients post acute myocardial infarction (AMI).
Objective:
To evaluate factors associated with post-AMI mortality during the one-year follow-up.
Materials And Methods:
The study is a prospective cohort study of adults aged 18 years and older with type 1 AMI conducted between October 2021 and January 2024. Intrahospital and outpatient information was collected. Statistical analyses included the Kaplan-Meier survival curve and Cox regression analysis. Proportional hazards and model predictive capacity were evaluated.
Results:
A total of 1873 patients were included, with a 9.4% mortality rate in the first year. At one year, the estimated survival probability was 88.61% (95% CI: 86.82-90.18). Cox analysis identified several factors associated with mortality, highlighting age (HR = 1.04, 95% CI: 1.02-1.06, p = 0.001), diabetes (HR = 1.77, 95% CI: 1.09-2.87, p = 0.020), renal insufficiency (HR = 2.25, 95% CI: 1.32-3.84, p = 0.003), and type of intervention. The model evaluation showed strong predictive capacity.
Conclusions:
It is essential to emphasize the importance of comprehensive management in AMI patients with risk factors such as diabetes and chronic kidney disease, as they are significant predictors of mortality during the first year post infarction.
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