10-Year Mortality After ST-Segment Elevation Myocardial Infarction Compared to the General Population

Area of Science:

• Cardiology
• Public Health
• Clinical Medicine

Background:

• ST-segment elevation myocardial infarction (STEMI) is a critical condition with significant early mortality.
• Long-term survival and excess mortality in STEMI patients after initial treatment remain incompletely understood.

Purpose of the Study:

• To evaluate the long-term excess mortality in STEMI patients treated with primary percutaneous coronary intervention (PCI).
• To compare mortality rates at landmark periods (0-30 days, 31-90 days, 91 days to 10 years) against an age- and sex-matched general population.

Main Methods:

• Utilized the Western Denmark Heart Registry to identify 18,818 first-time STEMI patients undergoing primary PCI (2003-2018).
• Matched each STEMI patient with 5 individuals from the general population based on age and sex.
• Analyzed mortality data at 0-30 days, 31-90 days, and 91 days to 10 years post-PCI.

Main Results:

• STEMI was associated with a 5.9% excess mortality in the first 30 days and 0.9% from 31-90 days.
• In STEMI survivors at 90 days, the 10-year excess mortality was only 2.1 percentage points (26.5% vs. 24.5%).
• High adherence to secondary preventive medications (statins, antiplatelet therapy, beta-blockers) was observed throughout the follow-up period.

Conclusions:

• STEMI patients treated with primary PCI who survive the initial 90 days experience only a modest increase in long-term mortality.
• The 10-year excess mortality for these survivors is approximately 2% compared to the general population.
• High utilization of guideline-recommended secondary preventive therapies contributes to favorable long-term outcomes in STEMI survivors.