scholarly journals Original Research: Long-Term Prognosis After ST-Elevation Myocardial Infarction in Patients with a Prior Cancer Diagnosis

2021 ◽  
Author(s):  
Julius C. Heemelaar ◽  
Elissa A. S. Polomski ◽  
Bart J. A. Mertens ◽  
J. Wouter Jukema ◽  
Martin J. Schalij ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cancer Diagnosis ◽  
St Elevation Myocardial Infarction ◽  
Original Research ◽  
St Elevation ◽  
Long Term Prognosis

scholarly journals Long-term prognosis after ST-elevation myocardial infarction in cancer patients

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
J C Heemelaar ◽  
E A S Polomski ◽  
B J A Mertens ◽  
J W Jukema ◽  
M J Schalij ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cancer Patients ◽  
Cause Of Death ◽  
Cancer Diagnosis ◽  
Cumulative Incidence ◽  
St Elevation Myocardial Infarction ◽  
St Elevation ◽  
Long Term Prognosis

Abstract Purpose To assess survival trends after ST-elevation myocardial infarction (STEMI) in patients with a prior cancer diagnosis and to evaluate the drivers of prognosis over a follow-up period of five years. Methods Patients with a known cancer diagnosis, admitted with STEMI between 2004–2014 and treated with primary PCI were recruited from the STEMI-clinical registry of our institution. Detailed information on cancer diagnosis, -stage, and treatment regimen were collected from the institutional and national cancer registry system and all patients were followed prospectively. Results In the 215 included patients the cumulative incidence of all-cause death after 5 years of follow-up was 38.2% (N=61). The cause of death was predominantly malignancy-related (N=29, 47.4% of deaths) and only 9 patients (14.8% of deaths) died of a cardiovascular cause. After correcting for age and sex – a recent cancer diagnosis (<1yr relative to >10 yr, HR 3.405 [95% CI: 1.552–7.470], p=0.002), distant metastasis at presentation (HR 2.603 [1.236–5.481], p=0.012), ongoing cancer treatment at presentation (HR 1.878 [1.015–3.475], p=0.045) and natural logarithm of maximum creatinine kinase level (HR 1.345 [1.044–1.733], p=0.022) were significant predictors of long-term mortality. While prevalent renal insufficiency showed significant association with all-cause mortality (HR 2.302 [1.289–4.111], p=0.005), other known determinants of long-term prognosis after STEMI – a history of diabetes mellitus (HR 1.250 [0.566–2.761], p=0.581), hypertension (HR 0.623 [0.393–1.085], p=0.150), and culprit vessel left anterior descending artery or left main artery (HR 1.066 [0.641–1.771], p=0.806) were not significantly associated with survival at 5-years follow-up. Conclusion Cancer patients admitted with STEMI have a poor survival with one third of patients died at 5 year follow up. Cancer was the most common cause of death and malignancy-related factors made a significant impact on prognosis, while most of the established cardiovascular determinants of prognosis were not significantly associated with long-term survival. FUNDunding Acknowledgement Type of funding sources: None. Cumulative incidence curve

P878Prevalence and prognosis of patients with myocardial infarction with nonobstructive coronary arteries: a nationwide registry based study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Janosi ◽  
T Ferenci ◽  
P Andreka
Keyword(s):  
Myocardial Infarction ◽  
Coronary Arteries ◽  
Obstructive Coronary Artery Disease ◽  
Population Level ◽  
St Elevation Myocardial Infarction ◽  
St Elevation ◽  
Artery Disease ◽  
Long Term Prognosis

Abstract Background There are conflicting data about the proportion and prognosis of patients (pts) with acute myocardial infarction (AMI) with nonobstructive coronary arteries (MINOCA). Purpose To define the incidence and prognosis of MINOCA pts in different types of AMI. Methods The Hungarian Myocardial Infarction Registry (HUMIR) is a nationwide, mandatory database in which the clinical and demographic informations of patients with AMI are recorded. Between January 1, 2014 and June 30, 2018, a total of 45,223 AMI (ST-elevation myocardial infarction (STEMI) n=22,469) pts were registered. After excluding pts with previous AMI, PCI, CABG, and congestive heart failure, 2003 MINOCA pts were found (MINOCA group), while 43,220 AMI pts had obstructive coronary artery disease (MI-CAD group). Results The proportion of pts with MINOCA disease was 4.4% among the total pts with AMI. The prevalence was higher in the non ST-elevation myocardial infarction (NSTEMI) group (n=1546, 6.8%) than in the STEMI (n=457, 2.0%) group. The pts with MINOCA disease were slightly younger compared to the pts with MI-CAD (mean age 64.0±14.4 vs. 65.5±12.2 years respectively). The proportion of women was higher in the MINOCA group than in the MI-CAD group (55.7% vs. 36.5%). At discharge, pts with MINOCA disease were less likely to be prescribed certain drugs compared to the pts with MI-CAD. These include aspirin (85.4% vs. 95.6%), RAAS blockers (83.8% vs. 90.4%), statins (86.2% vs. 94.7%), β-blockers (86.8% vs. 89.8%) for the MINOCA and MI-CAD groups respetively. At the 1-year follow-up, the incidence of new AMI events was 1.6% in the MINOCA group compared with 5.0% in the MI-CAD group (HR=2.79). All-cause mortality was higher among the pts with MI-CAD compared to the pts with MINOCA disease. In the MINOCA group, among the pts with NSTEMI, men and women had similar outcomes at 30 days, but men had somewhat higher mortality at one and two years. In contrast, in the STEMI group, women had higher mortality compared to men at all time points during the study (Table 1). Mortality among MINOCA and MI-CAD pts Mortality MINOCA (n=2003) MI-CAD (n=43,220) MINOCA – STEMI MINOCA – NSTEMI Men (n=218) Women (n=239) Men (n=669) Womenr (n=877) 30-day 5.9% [4.9–7.0] 8.4% [8.1–8.7] 8.7% [4.9–12.4] 13.4% [9–17.6] 4.3% [2.8–5.9] 4.4% [3.1–5.8] 1-year 12.5% [11.0–14.0] 15.6% [15.3–16.0] 12.1% [7.6–16.4] 20.3% [15–25.2] 12.2% [9.6–14.7] 10.8% [8.7–12.8] 2-year 16.7% [14.9–18.5] 19.9% [19.5–20.3] 18.2% [12.4–23.6] 23.6% [17.8–29] 16.9% [13.8–20] 14.3% [11.7–16.7] 95% confidence interval in brackets. Conclusion The population-level incidence of MINOCA disease was 4.4% in AMI; the incidence was higher in the NSTEMI group compared to the STEMI group (6.8% vs. 2.0%). Despite the benign anatomy, the long-term prognosis is poor, especially in women after STEMI: 1 out of 4 pts died at the two-year follow up. Acknowledgement/Funding None

Relationship of long-term prognosis to MMP and TIMP polymorphisms in patients after ST elevation myocardial infarction

2017 ◽  
Vol 58 (3) ◽  
pp. 331-341 ◽  
Author(s):  
Monika Pavkova Goldbergova ◽  
Jiri Jarkovsky ◽  
Jolana Lipkova ◽  
Simona Littnerova ◽  
Martin Poloczek ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
St Elevation Myocardial Infarction ◽  
St Elevation ◽  
Long Term Prognosis ◽  
Relationship Of

scholarly journals INFLUENCE OF RETHROMBOSIS OF INFARCTION-RELATED ARTERY AFTER THROMBOLYSIS ON SHORTEST TERM AND LONG TERM PROGNOSIS OF ST ELEVATION MYOCARDIAL INFARCTION

2017 ◽  
Vol 16 (4) ◽  
pp. 31-36
Author(s):  
E. A. Shigotarova ◽  
Yu. A. Tomashevskaya ◽  
I. B. Matrosova ◽  
A. V. Golubeva ◽  
V. E. Oleynikov
Keyword(s):  
Myocardial Infarction ◽  
St Elevation Myocardial Infarction ◽  
St Elevation ◽  
Long Term Prognosis

scholarly journals Serum Total Bilirubin and Long-Term Prognosis of Patients With New-Onset Non-ST Elevation Myocardial Infarction: A Cohort Study

2021 ◽  
Author(s):  
Yi Yang ◽  
Jun Wang ◽  
A Ji Gu Li Wai Si Ding ◽  
Yanan Xu ◽  
Haibing Jiang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Total Bilirubin ◽  
St Elevation Myocardial Infarction ◽  
The Third ◽  
Increased Risk ◽  
St Elevation ◽  
Coronary Lesions ◽  
Long Term Prognosis ◽  
New Onset

Abstract Background: The potential prognostic role of total bilirubin (TBIL) in patients with new-onset non-ST elevation myocardial infarction (NSTEMI) is not fully understood. This study aims to evaluate the potential predictive value of TBIL for long-term prognosis in patients with new-onset NSTEMI.Methods: Patients with new-onset NSTEMI that underwent emergency coronary angiography in our department from June 2015 to March 2020 were included. Baseline TBIL was measured at admission. SYNTAX scores were used to indicate the severity of coronary lesions. The association between TBIL and SYNTAX scores was analyzed using multivariate logistic regression. The patients were followed for the incidence of major adverse cardiac and cerebrovascular events (MACCEs). The association between TBIL and MACCEs was analyzed using Kaplan–Meier survival methods.Results: In total 327 patients were included in this study. Patients were divided according to tertiles of TBIL (first tertile <10.23 µmol/L, n = 109; second tertile 10.23–14.30 µmol/L, n = 109; and third tertile ≥14.30 µmol/L, n = 109). TBIL was independently associated with the severity of coronary lesions in patients with NSTEMI, with an adjusted odds ratio (OR) and 95% confidence interval (CI) for the third tertile and the second tertile compared with the first tertile of TBIL of 2.259 (1.197-4.263) and 2.167 (1.157-4.059), respectively (both p<0.05). After a mean follow-up of 30.33 months, MACCE had occurred in 57 patients. TBIL was independently associated with the increased risk of MACCEs, with an adjusted hazard ratio (HR) and 95% CI for the third tertile and the second tertile compared with the first tertile of TBIL of 2.737 (1.161 -6.450) and 3.272 (1.408-7.607), respectively (both p<0.05).Conclusions: Higher myocardial infarction admission TBIL might independently predict poor prognosis in patients with NSTEMI.

Long-term prognosis after primary PCI in unselected patients with ST-elevation myocardial infarction

2012 ◽  
Vol 13 (12) ◽  
pp. 819-827 ◽  
Author(s):  
Alessandro Barchielli ◽  
Giovanni M. Santoro ◽  
Daniela Balzi ◽  
Nazario Carrabba ◽  
Mauro Di Bari ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
St Elevation Myocardial Infarction ◽  
Primary Pci ◽  
St Elevation ◽  
Long Term Prognosis
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