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Mortality pattern and cause of death in a long-term follow-up of patients with STEMI treated with primary PCI.

Doost Hosseiny A, Moloi S, Chandrasekhar J, Farshid A - Open Heart (2016)

Bottom Line: In the era of routine primary PCI, we found a mortality rate of 7.3% at 1 year, and 2.05% per year thereafter.Cause of death was predominantly cardiovascular in the first year and mainly non-cardiovascular after 1 year.Age, diabetes, prior PCI, cardiogenic shock, eGFR <60 and delayed treatment were independent predictors of mortality.

View Article: PubMed Central - PubMed

Affiliation: Cardiology Department , The Canberra Hospital , Garran, Australian Capital Territory , Australia.

ABSTRACT

Objective: We aimed to assess the pattern of mortality and cause of death in a cohort of patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI).

Methods: Consecutive patients with STEMI treated with primary PCI during 2006-2013 were evaluated with a mean follow-up of 3.5 years (1-8.4 years). We used hospital and general practice records and mortality data from The Australian National Death Index.

Results: Among 1313 patients (22.5% female) with mean age of 62.3±13.1 years, 181 patients (13.7%) died during long-term follow-up. In the first 7 days, 45 patients (3.4%) died, 76% of these due to cardiogenic shock. Between 7 days and 1 year, another 50 patients died (3.9%), 58% from cardiovascular causes and 22% from cancer. Beyond 1 year, there were 86 deaths with an estimated mean mortality rate of 2.05% per year, 36% of deaths were cardiovascular and 52% non-cardiovascular, including 29% cancer-related deaths. On multivariate analysis, age ≥75 years, history of diabetes, prior PCI, cardiogenic shock, estimated glomerular filtration rate (eGFR) <60 and symptom-to-balloon time >360 min were independent predictors of long-term mortality. In 16 patients who died of sudden cardiac death postdischarge, only 4 (25%) had ejection fraction ≤35% and would have been eligible for an implantable cardioverter defibrillator.

Conclusions: In the era of routine primary PCI, we found a mortality rate of 7.3% at 1 year, and 2.05% per year thereafter. Cause of death was predominantly cardiovascular in the first year and mainly non-cardiovascular after 1 year. Age, diabetes, prior PCI, cardiogenic shock, eGFR <60 and delayed treatment were independent predictors of mortality.

No MeSH data available.


Related in: MedlinePlus

Percentage of mortality from cardiovascular or non-cardiovascular causes during specified phases after primary PCI. PCI, percutaneous coronary intervention.
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OPENHRT2016000405F2: Percentage of mortality from cardiovascular or non-cardiovascular causes during specified phases after primary PCI. PCI, percutaneous coronary intervention.

Mentions: Cause of death was distinctly different in patients in these time intervals (tables 5 and 6 and figure 2). During the first week, cardiovascular causes were responsible for 98% of deaths (76% of these due to cardiogenic shock). Between 7 days and 1 year, cardiovascular causes accounted for 58% and malignancy for 22% of all deaths. After 1 year, 36% of deaths were cardiovascular and 52% non-cardiovascular, including cancer which accounted for 29% of all deaths. Cause of death was undetermined in 14 patients (8%).


Mortality pattern and cause of death in a long-term follow-up of patients with STEMI treated with primary PCI.

Doost Hosseiny A, Moloi S, Chandrasekhar J, Farshid A - Open Heart (2016)

Percentage of mortality from cardiovascular or non-cardiovascular causes during specified phases after primary PCI. PCI, percutaneous coronary intervention.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4836287&req=5

OPENHRT2016000405F2: Percentage of mortality from cardiovascular or non-cardiovascular causes during specified phases after primary PCI. PCI, percutaneous coronary intervention.
Mentions: Cause of death was distinctly different in patients in these time intervals (tables 5 and 6 and figure 2). During the first week, cardiovascular causes were responsible for 98% of deaths (76% of these due to cardiogenic shock). Between 7 days and 1 year, cardiovascular causes accounted for 58% and malignancy for 22% of all deaths. After 1 year, 36% of deaths were cardiovascular and 52% non-cardiovascular, including cancer which accounted for 29% of all deaths. Cause of death was undetermined in 14 patients (8%).

Bottom Line: In the era of routine primary PCI, we found a mortality rate of 7.3% at 1 year, and 2.05% per year thereafter.Cause of death was predominantly cardiovascular in the first year and mainly non-cardiovascular after 1 year.Age, diabetes, prior PCI, cardiogenic shock, eGFR <60 and delayed treatment were independent predictors of mortality.

View Article: PubMed Central - PubMed

Affiliation: Cardiology Department , The Canberra Hospital , Garran, Australian Capital Territory , Australia.

ABSTRACT

Objective: We aimed to assess the pattern of mortality and cause of death in a cohort of patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI).

Methods: Consecutive patients with STEMI treated with primary PCI during 2006-2013 were evaluated with a mean follow-up of 3.5 years (1-8.4 years). We used hospital and general practice records and mortality data from The Australian National Death Index.

Results: Among 1313 patients (22.5% female) with mean age of 62.3±13.1 years, 181 patients (13.7%) died during long-term follow-up. In the first 7 days, 45 patients (3.4%) died, 76% of these due to cardiogenic shock. Between 7 days and 1 year, another 50 patients died (3.9%), 58% from cardiovascular causes and 22% from cancer. Beyond 1 year, there were 86 deaths with an estimated mean mortality rate of 2.05% per year, 36% of deaths were cardiovascular and 52% non-cardiovascular, including 29% cancer-related deaths. On multivariate analysis, age ≥75 years, history of diabetes, prior PCI, cardiogenic shock, estimated glomerular filtration rate (eGFR) <60 and symptom-to-balloon time >360 min were independent predictors of long-term mortality. In 16 patients who died of sudden cardiac death postdischarge, only 4 (25%) had ejection fraction ≤35% and would have been eligible for an implantable cardioverter defibrillator.

Conclusions: In the era of routine primary PCI, we found a mortality rate of 7.3% at 1 year, and 2.05% per year thereafter. Cause of death was predominantly cardiovascular in the first year and mainly non-cardiovascular after 1 year. Age, diabetes, prior PCI, cardiogenic shock, eGFR <60 and delayed treatment were independent predictors of mortality.

No MeSH data available.


Related in: MedlinePlus