scholarly journals Impact of cancer on short-term in-hospital mortality after primary acute myocardial infarction

Open Heart ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. e001860
Author(s):  
Robert Zheng ◽  
Kenya Kusunose ◽  
Yuichiro Okushi ◽  
Yoshihiro Okayama ◽  
Michikazu Nakai ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Mortality ◽  
Large Scale ◽  
Total Mortality ◽  
Short Term ◽  
Diagnosis Procedure Combination ◽  
Patients With Cancer ◽  
Cancer Group ◽  
The Impact

BackgroundCardiovascular diseases are the second most common cause of mortality among cancer survivors, after death from cancer. We sought to assess the impact of cancer on the short-term outcomes of acute myocardial infarction (AMI), by analysing data obtained from a large-scale database.MethodsThis study was based on the Diagnosis Procedure Combination database in the Japanese Registry of All Cardiac and Vascular Diseases and the Diagnosis Procedure Combination. We identified patients who were hospitalised for primary AMI between April 2012 and March 2017. Propensity Score (PS) was estimated with logistic regression model, with cancer as the dependent variable and 21 clinically relevant covariates. The main outcome was in-hospital mortality.ResultsWe split 1 52 208 patients into two groups with or without cancer. Patients with cancer tended to be older (cancer group 73±11 years vs non-cancer group 68±13 years) and had smaller body mass index (cancer group 22.8±3.6 vs non-cancer 23.9±4.3). More patients in the non-cancer group had hypertension or dyslipidaemia than their cancer group counterparts. The non-cancer group also had a higher rate of percutaneous coronary intervention (cancer 92.6% vs non-cancer 95.2%). Patients with cancer had a higher 30-day mortality (cancer 6.0% vs non-cancer 5.3%) and total mortality (cancer 8.1% vs non-cancer 6.1%) rate, but this was statistically insignificant after PS matching.ConclusionCancer did not significantly impact short-term in-hospital mortality rates after hospitalisation for primary AMI.

The effect of preloading statins prior to primary reperfusion on in-hospital mortality risk in a contemporary large-scale cohort of patients with ST-elevation myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
R Fu ◽  
C.X Song ◽  
X.D Li ◽  
Y.J Yang
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Mortality ◽  
Mortality Risk ◽  
Large Scale ◽  
Reperfusion Therapy ◽  
St Elevation Myocardial Infarction ◽  
Control Group ◽  
Funding Source ◽  
St Elevation

Abstract Background The benefit of statins in secondary prevention of patients stabilized after acute coronary syndrome (ACS) has been well established. However, the benefit of preloading statins, i.e. high-intensity statins prior to reperfusion therapy remains unclear. Most previous studies included all types of ACS patients, and subgroup analysis indicated the benefit of preloading statins was only seen in ST-elevation myocardial infarction (STEMI) patients who underwent percutaneous coronary intervention (PCI). However, the sample size of subgroup population was relatively small and such benefit requires further validation. Objective To investigate the effect of loading dose of statins before primary reperfusion on 30-mortality in patients with STEMI. Methods We enrolled patients in China Acute Myocardial Infarction (CAMI) registry from January 2013 to September 2014. CAMI registry was a prospective multicenter registry of patients with acute acute myocardial infarction in China. Patients were divided into two groups according to statins usage: preloading group and control group. Patients in preloading group received loading does of statins before primary reperfusion and during hospitalization. Patients in control group did not receive statins during hospitalization or at discharge. Primary outcome was in-hospital mortality. Baseline characteristics, angiographic characteristics and outcome were compared between groups. Propensity score (PS) matching was used to mitigate baseline differences between groups and examine the association between preloading statins on in-hospital mortality risk. The following variables were used to establish PS matching score: age, sex, classification of hospitals, clinical presentation (heart failure at presentation, cardiac shock, cardiac arrest, Killip classification), hypertension, diabetes, prior angina, prior myocardial infarction history, prior stroke, initial treatment. Results A total of 1169 patients were enrolled in control group and 6795 in preloading group. A total of 833 patients (334 in control group and 499 in preloading group) died during hospitalization. Compared with control group, preloading group were younger, more likely to be male and present with Killip I classification. The proportion of hypertension and diabetes were higher in preloading group. After PS matching, all the variables used to generate PS score were well balanced. In the PS-matched cohort, 30-day mortality risk was 26.3% (292/1112) in the control group and 11.9% (132/1112) in the preloading group (p<0.0001). Conclusions The current study found preloading statins treatment prior to reperfusion therapy reduced in-hospital mortality risk in a large-scale contemporary cohort of patients with STEMI. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Chinese Academy of Medical Sciences

scholarly journals Effect of Short-Term Exposure to Fine Particulate Matter and Temperature on Acute Myocardial Infarction in Korea

2021 ◽  
Vol 18 (9) ◽  
pp. 4822
Author(s):  
Jiyoung Shin ◽  
Jongmin Oh ◽  
In Sook Kang ◽  
Eunhee Ha ◽  
Wook Bum Pyun
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Particulate Matter ◽  
Fine Particulate Matter ◽  
Ambient Air ◽  
Cold Season ◽  
Short Term ◽  
Fine Particulate ◽  
Short Term Exposure ◽  
The Impact

Background/Aim: Previous studies have suggested that the short-term ambient air pollution and temperature are associated with myocardial infarction. In this study, we aimed to conduct a time-series analysis to assess the impact of fine particulate matter (PM2.5) and temperature on acute myocardial infarction (AMI) among adults over 20 years of age in Korea by using the data from the Korean National Health Information Database (KNHID). Methods: The daily data of 192,567 AMI cases in Seoul were collected from the nationwide, population-based KNHID from 2005 to 2014. The monitoring data of ambient PM2.5 from the Seoul Research Institute of Public Health and Environment were also collected. A generalized additive model (GAM) that allowed for a quasi-Poisson distribution was used to analyze the effects of PM2.5 and temperature on the incidence of AMI. Results: The models with PM2.5 lag structures of lag 0 and 2-day averages of lag 0 and 1 (lag 01) showed significant associations with AMI (Relative risk [RR]: 1.011, CI: 1.003–1.020 for lag 0, RR: 1.010, CI: 1.000–1.020 for lag 01) after adjusting the covariates. Stratification analysis conducted in the cold season (October–April) and the warm season (May–September) showed a significant lag 0 effect for AMI cases in the cold season only. Conclusions: In conclusion, acute exposure to PM2.5 was significantly associated with AMI morbidity at lag 0 in Seoul, Korea. This increased risk was also observed at low temperatures.

scholarly journals Difference in the in-hospital prognosis between ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction with high Killip class: Data from the Japan Acute Myocardial Infarction Registry

2020 ◽  
pp. 204887262092668
Author(s):  
Motoki Fukutomi ◽  
Kensaku Nishihira ◽  
Satoshi Honda ◽  
Sunao Kojima ◽  
Misa Takegami ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Mortality ◽  
Short Term ◽  
Term Outcome ◽  
Killip Class ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Significant Difference

Background ST-segment elevation myocardial infarction is known to be associated with worse short-term outcome than non-ST-segment elevation myocardial infarction. However, whether or not this trend holds true in patients with a high Killip class has been unclear. Methods We analyzed 3704 acute myocardial infarction patients with Killip II–IV class from the Japan Acute Myocardial Infarction Registry and compared the short-term outcomes between ST-segment elevation myocardial infarction ( n = 2943) and non-ST-segment elevation myocardial infarction ( n = 761). In addition, we also performed the same analysis in different age subgroups: <80 years and ≥80 years. Results In the overall population, there were no significant difference in the in-hospital mortality (20.0% vs 17.1%, p = 0.065) between ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction groups. Patients <80 years of age also showed no difference in the in-hospital mortality (15.7% vs 15.2%, p = 0.807) between ST-segment elevation myocardial infarction ( n = 2001) and non-ST-segment elevation myocardial infarction ( n = 453) groups, whereas among those ≥80 years of age, ST-segment elevation myocardial infarction ( n = 942) was associated with significantly higher in-hospital mortality (29.3% vs 19.8%, p = 0.001) and in-hospital cardiac mortality (23.3% vs 15.0%, p = 0.002) than non-ST-segment elevation myocardial infarction ( n = 308). After adjusting for covariates, ST-segment elevation myocardial infarction was a significant predictor for in-hospital mortality (odds ratio 2.117; 95% confidence interval, 1.204–3.722; p = 0.009) in patients ≥80 years of age. Conclusion Among cases of acute myocardial infarction with a high Killip class, there was no marked difference in the short-term outcomes between ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction in younger patients, while ST-segment elevation myocardial infarction showed worse short-term outcomes in elderly patients than non-ST-segment elevation myocardial infarction. Future study identifying the prognostic factors for the specific anticipation intensive cares is needed in this high-risk group.

P686Cancer is not associated with increased cardiac and bleeding events after 2nd- and 3rd-generation drug-eluting stents implantation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
Y Muramatsu ◽  
Y Minami ◽  
K Ishida ◽  
A Kato ◽  
A Katsura ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Intervention ◽  
Drug Eluting Stent ◽  
Cardiac Events ◽  
Bleeding Events ◽  
Patients With Cancer ◽  
Cancer Group ◽  
Increased Risk ◽  
Drug Eluting ◽  
The Impact

Abstract Background Previous studies demonstrated the impact of concomitant cancer on the increased risk of adverse cardiac and bleeding events after percutaneous coronary intervention (PCI). However, the impact in this 2nd- and 3rd-generation drug-eluting stent (DES) era remains to be elucidated. Purpose To clarify the impact of cancer on clinical outcomes in patients after 2nd- or 3rd -generation DES implantation. Methods A total of 932 patients who underwent PCI with 2nd- or 3rd -generation DES were included. Patients who were diagnosed with cancer after PCI were excluded from the present cohort. The incidence of major adverse cardiac events (MACE) including cardiac death, myocardial infarction and target or non-target vessel revascularization, and bleeding events was compared between the patients with cancer or the history of treatment for cancer (cancer group, n=140) and the patients without cancer (no cancer group, n=792). Bleeding events were evaluated according to the Thrombolysis in Myocardial Infarction definition. Further comparisons were performed between the 2 groups (cancer group, n=126; no cancer group, n=252) after the adjustment of baseline clinical characteristics using 1:2 propensity score-matching analysis. Results The incidence of MACE at median 577 [340–1043] days after the PCI was comparable between the 2 groups in both unadjusted (15.0% vs. 15.0%, p=0.984) (Panel A) and adjusted cohorts (14.3 vs. 13.1%, p=0.796), although the incidence of all cause death in the cancer group was significantly greater than the no cancer group (15.1 vs. 9.5%, p=0.007, in the adjusted cohort). The increased risk of MACE was not observed in any types of cancer or treatment (Panel B). The incidence of bleeding events was also comparable between the 2 groups (4.0 vs. 2.0%, p=0.297, in the adjusted cohort). Conclusion The increased incidence of MACE and bleeding events in patients with cancer was not demonstrated after the 2nd- or 3rd-generation DES implantation. Further studies are required to clarify the safety and efficacy of PCI in patients with cancer.

Abstract 17382: Gender Difference in Presentation, Management and Outcome of Patients With Acute Myocardial Infarction: A Sub-analysis of J-MINUET Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Yasuharu Nakama ◽  
Masaharu Ishihara ◽  
Masashi Fujino ◽  
Hisao Ogawa ◽  
Koichi Nakao ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Gender Difference ◽  
Hospital Mortality ◽  
Current Smoking ◽  
Killip Class ◽  
Universal Definition ◽  
The Impact

Purpose: Several studies have reported gender difference in presentation, management and outcome in patients with acute myocardial infarction (AMI). In this study, we focused the impact of age on gender difference in mortality after AMI. Methods: Between July 2012 and March 2014, 3283 patients were admitted to the 28 hospitals participating to the J-MINUET group within 48 hours after the onset of AMI. AMI was diagnosed by universal definition (type 1 or type 2). Patients were divided into 5 strata according to their age: those with age <55 years, 55-64 years, 65-74 years, 75-84 years and ≥85 years. Results: There were 813 women (24.8%). Women were significantly older than men (74.5±11.8 years vs 66.6±12.3 years, P<0.001). Women had longer time from onset to admission, more NSTEMI, atypical symptom other than chest pain, Killip class ≥2, CKD and type 2 MI. They also had less diabetes and current smoking habits. Although most of the patients received urgent angiography (93.1%), it was less frequent in women (90.4% vs 94.0%, P<0.001). Among patients who underwent primary PCI (85.1%), achievement of final TIMI-3 flow was similar (91.2% vs 92.0%, P=0.53). In-hospital mortality was significantly higher in women than men (9.6% vs 5.5%, P<0.001). When patients were stratified according to their age, there was a liner increase in the prevalence of women as age advanced: 10.6% in <55 years, 15.1% in 55-64 years, 19.8% in 65-74 years, 35.6% in 75-84 years and 53.6% in ≥85 years (P<0.001). There was no significant gender difference in mortality in each stratum (Figure). Multivariate analysis showed that women was no more an independent predictor of death after adjusting age (OR 1.29, 95%CI 0.95-1.75, P=0.10), or age and other variables (OR 1.19, 95%CI 0.79-1.76, P=0.40). Conclusions: Women had higher in-hospital mortality than men after AMI even in the contemporary troponin era. However, their high mortality was mostly explained by their advanced age.

AS-254: The Impact of Early Increase in Serum Creatinine on In-hospital Mortality in Patients with Acute Myocardial Infarction

2012 ◽  
Vol 109 (7) ◽  
pp. S124
Author(s):  
Satoshi Okumura ◽  
Ryo Hayashida ◽  
Yasushi Jinno ◽  
Akihito Tanaka ◽  
Koji Okada ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Serum Creatinine ◽  
Hospital Mortality ◽  
Early Increase ◽  
The Impact

scholarly journals Impact of Admission Hyperglycemia on Short and Long-Term Prognosis in Acute Myocardial Infarction: MINOCA versus MIOCA

2021 ◽  
Author(s):  
Pasquale Paolisso ◽  
Alberto Foà ◽  
Luca Bergamaschi ◽  
Francesco Angeli ◽  
Michele Fabrizio ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Mortality ◽  
Coronary Arteries ◽  
Hospital Death ◽  
Diabetic Patients ◽  
Long Term Outcomes ◽  
Short And Long Term ◽  
The Impact

Abstract BackgroundThe prognostic role of hyperglycemia in patients with myocardial infarction and obstructive coronary arteries (MIOCA) is acknowledged, while data on non-obstructive coronary arteries (MINOCA) are still lacking. Recently, we demonstrated that admission stress-hyperglycemia (aHGL) was associated with a larger infarct size and inflammatory response in MIOCA, while no differences were observed in MINOCA. We aim to investigate the impact of aHGL on short and long-term outcomes in MIOCA and MINOCA patients.MethodsMulticenter, population-based, cohort study of the prospective registry, designed to evaluate the prognostic information of patients admitted with acute myocardial infarction to S. Orsola-Malpighi and Maggiore Hospitals of Bologna metropolitan area. Among 2704 patients enrolled from 2016 to 2020, 2431 patients were classified according to the presence of aHGL (defined as admission glucose level ≥ 140mg/dL) and AMI phenotype (MIOCA/MINOCA): no-aHGL (n = 1321), aHGL (n = 877) in MIOCA and no-aHGL (n = 195), aHGL (n = 38) in MINOCA. Short-term outcomes included in-hospital death and arrhythmias. Long-term outcomes were all-cause and cardiovascular mortality.ResultsaHGL was associated with a higher in-hospital arrhythmic burden in MINOCA and MIOCA, with increased in-hospital mortality only in MIOCA. After adjusting for age, gender, hypertension, Killip class and AMI phenotypes, aHGL predicted higher in-hospital mortality in non-diabetic (HR = 4.2; 95% CI 1.9–9.5, p = 0.001) and diabetic patients (HR = 3.5, 95% CI 1.5–8.2, p = 0.003). During long-term follow-up, aHGL was associated with 2-fold increased mortality in MIOCA and a 4-fold increase in MINOCA (p = 0.032 and p = 0.016). Kaplan Meier 3-year survival of non-hyperglycemic patients was greater than in aHGL patients for both groups. No differences in survival were found between hyperglycemic MIOCA and MINOCA patients. After adjusting for age, gender, hypertension, smoking, LVEF, STEMI/NSTEMI and AMI phenotypes (MIOCA/MINOCA), aHGL predicted higher long-term mortality.ConclusionsaHGL was identified as a strong predictor of adverse short- and long-term outcomes in both MIOCA and MINOCA, regardless of diabetes. aHGL should be considered a high-risk prognostic marker in all AMI patients, independently of the underlying coronary anatomy.Trial Registrationdata were part of the ongoing observational study AMIPE: Acute Myocardial Infarction, Prognostic and Therapeutic Evaluation. ClinicalTrials.gov Identifier: NCT03883711.

Peripheral artery disease is associated with high in-hospital mortality particularly in males with acute myocardial infarction in a nationwide real-world setting

VASA ◽  
2016 ◽  
Vol 45 (2) ◽  
pp. 169-174 ◽  
Author(s):  
Eva Freisinger ◽  
Nasser M. Malyar ◽  
Holger Reinecke
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Mortality ◽  
Real World ◽  
Large Scale ◽  
Female Gender ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Cardiovascular Morbidity And Mortality

Abstract. Background: Patients with peripheral arterial disease (PAD) are at high risk for cardiovascular morbidity and mortality. The objective of this nationwide analysis was to explore the association of PAD with in-hospital mortality in patients hospitalized for acute myocardial infarction (AMI). Patients and methods: Data on all in-patient hospitalizations in Germany are continuously transferred to the Federal Statistical Office (DESTATIS), as required by federal law. These case-based data on AMI in the years 2005, 2007 and 2009 were analyzed regarding ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) as the primary diagnoses and concomitant PAD as the secondary diagnosis with respect to age and gender related disparity. Results: We analyzed 619,103 AMI cases, including 270,026 (43.6 %) with STEMI and 349,077 (56.4 %) with NSTEMI. The PAD ratio was 3.4 % in STEMI and 5.7 % in NSTEMI. In STEMI, in-hospital mortality was 15.6 % in cases with PAD vs. 12.0 % without, and 12.0 % vs. 9.8 % in NSTEMI, respectively (P < 0.001; 2009). Although female gender was associated with a significantly higher in-hospital mortality, the presence of PAD particularly negatively affected in-hospital mortality in men (+ 60 % male vs - 11 % female in STEMI; + 33 % male vs - 3 % female in NSTEMI). Conclusions: Our data demonstrate the adverse impact of concomitant PAD on in-hospital mortality in AMI, in a large-scale, real-world scenario. Further research, particularly with a focus on gender, is needed to identify diagnostic and therapeutic measures to reduce the remarkably high in-hospital mortality of AMI patients with concomitant PAD.

The impact of low diastolic blood pressure on 30-day mortality of patients with acute myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Asano ◽  
Y Mitsuhashi ◽  
M Sachi ◽  
K Wakabayashi ◽  
K Yahagi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Acute Myocardial Infarction ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Diastolic Blood Pressure ◽  
Multivariate Logistic Regression Analysis ◽  
Term Outcome ◽  
Time Of Admission ◽  
The Impact

Abstract Background It is known that low diastolic blood pressure (DBP) is associated with long-term cardiovascular events after acute myocardial infarction (AMI). However, the impact of low diastolic blood pressure on short-term outcome has not yet been well investigated. Methods and results We included 15,208 patients who were hospitalized for AMI and registered in the Tokyo CCU network registry between 2013 and 2016. Thirty-day in-hospital mortality rate was 4.8% (728/15,208). To assess the relationship between DBP at the time of admission and 30-day mortality non-linearly, spline regression model was applied with the stratification of the cohort according to tercile of systolic blood pressure (SBP, low:≤122 mmHg, intermediate:123–148 mmHg, high:≥149 mmHg) and J-curve phenomenon was observed in the low and high SBP groups. In multivariate logistic regression analysis, adjusted odds ratio of the lowest quintile of DBP (≤64 mmHg) was 1.65 (95% CI:1.02–2.66) in low SBP group and 4.55 (95% CI:1.72–12.00) in high SBP group. Conclusion Low DBP was associated with increased 30-day in-hospital mortality rate after AMI even in patients with high SBP. Funding Acknowledgement Type of funding source: None

Sign in / Sign up

Export Citation Format

Share Document