scholarly journals Short and Long-term Survival Rates following Myocardial Infarction and its Predictive Factors: A Study Using National Registry Data

2021 ◽  
Author(s):  
Samaneh Mozaffarian ◽  
Korosh Etemad ◽  
Mohammad Aghaali ◽  
Soheila Khodakarim ◽  
Sahar Sotoodeh Ghorbani ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Disease ◽  
Predictive Factors ◽  
Survival Rates ◽  
Term Survival ◽  
Risk Of Death ◽  
Chronic Heart Disease ◽  
History Of ◽  
Short And Long Term

Background: Coronary artery disease is the most common cause of death worldwide as well as in Iran. The present study was designed to predict short and long-term survival rates after the first episode of myocardial infarction (MI). Methods: The current research is a retrospective cohort study. The data were collected from the Myocardial Infarction Registry of Iran in a 12-month period leading to March 20, 2014. The variables analyzed included smoking status, past medical history of chronic heart disease, hypertension, diabetes, hyperlipidemia, signs and symptoms during an attack, post-MI complications during hospitalization, the occurrence of arrhythmias, the location of MI, and the place of residence. Survival rates and predictive factors were estimated by the Kaplan–Meier method, the log-rank test, and the Cox model. Results: Totally, 21 181 patients with the first MI were studied. There were 15 328 men (72.4%), and the mean age of the study population was 62.10±13.42 years. During a 1-year period following MI, 2479 patients (11.7%) died. Overall, the survival rates at 28 days, 6 months, and 1 year were estimated to be 0.95 (95% CI: 0.95 to 0.96), 0.90 (95% CI: 0.90 to 0.91), and 0.88 (95% CI: 0.88 to 0.89). After the confounding factors were controlled, history of chronic heart disease (p<0.001), hypertension (p<0.001), and diabetes (p<0.001) had a significant relationship with an increased risk of death and history of hyperlipidemia (p<0.001) and inferior wall MI (p<0.001) had a significant relationship with a decreased risk of death. Conclusion: The results of this study provide evidence for health policy-makers and physicians on the link between MI and its predictive factors.

Transapical versus Conventional Aortic Valve Replacement�A Propensity-Matched Comparison

2012 ◽  
Vol 15 (1) ◽  
pp. 4 ◽  
Author(s):  
David M. Holzhey ◽  
William Shi ◽  
A. Rastan ◽  
Michael A. Borger ◽  
Martin H�nsig ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Survival Rates ◽  
Long Term Results ◽  
Term Survival ◽  
Kaplan Meier ◽  
Risk Patients ◽  
Short And Long Term ◽  
Good Treatment Option ◽  
Matched Comparison

<p><b>Introduction:</b> The goal of this study was to compare the short- and long-term outcomes after aortic valve (AV) surgery carried out via standard sternotomy/partial sternotomy versus transapical transcatheter AV implantation (taTAVI).</p><p><b>Patients and Methods:</b> All 336 patients who underwent taTAVI between 2006 and 2010 were compared with 4533 patients who underwent conventional AV replacement (AVR) operations between 2001 and 2010. Using propensity score matching, we identified and consecutively compared 2 very similar groups of 167 patients each. The focus was on periprocedural complications and long-term survival.</p><p><b>Results:</b> The 30-day mortality rate was 10.8% and 8.4% (<i>P</i> = .56) for the conventional AVR patients and the TAVI patients, respectively. The percentages of postoperative pacemaker implantations (15.0% versus 6.0%, <i>P</i> = .017) and cases of renal failure requiring dialysis (25.7% versus 12.6%, <i>P</i> = .004) were higher in the TAVI group. Kaplan-Meier curves diverged after half a year in favor of conventional surgery. The estimated 3-year survival rates were 53.5% � 5.7% (TAVI) and 66.7% � 0.2% (conventional AVR).</p><p><b>Conclusion:</b> Our study shows that even with all the latest successes in catheter-based AV implantation, the conventional surgical approach is still a very good treatment option with excellent long-term results, even for older, high-risk patients.</p>

scholarly journals Genetic Alterations in Patients With Esophageal Cancer With Short- and Long-Term Survival Rates After Curative Esophagectomy

1997 ◽  
Vol 226 (2) ◽  
pp. 162-168 ◽  
Author(s):  
Yutaka Shimada ◽  
Masayuki Imamura ◽  
Ichio Shibagaki ◽  
Hisashi Tanaka ◽  
Tokiharu Miyahara ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Survival Rates ◽  
Genetic Alterations ◽  
Term Survival ◽  
Long Term Survival ◽  
Short And Long Term ◽  
Curative Esophagectomy

Abstract P101: Short and Long-Term Outcomes in Aspirin Treated PCI Patients Using NSAIDs

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Rizwan Alimohammad ◽  
Sayed Tariq ◽  
Ali Elkharbotly ◽  
Ed Timm ◽  
Mikhail Torosoff
Keyword(s):  
Myocardial Infarction ◽  
Rank Test ◽  
Long Term Outcomes ◽  
Chi Square ◽  
Low Dose Aspirin ◽  
History Of ◽  
Short And Long Term ◽  
Mortality Table ◽  
Prolonged Hospital

Background: NSAIDs may exert direct deleterious effects on CV system, while non-selective (NS) -NSAIDs may also diminish cardio-protective effect of low-dose aspirin. On another hand, NSAIDs may decrease CRP levels and ameliorate systemic inflammation. We have investigated short and long-term outcomes associated with NSAIDs use in post-PCI patients. Methods and Material: NSAID utilization, hospital and long-term outcomes of 2933 percutaneous coronary revascularizations (PCI) were collected and analyzed. Patients not on aspirin, or treated with rofecoxib and valdecoxib were excluded. ANOVA, Chi-square, Kaplan-Meyer analysis with log-rank test, and logistic regression were utilized. The study was approved by the Institutional IRB. Results: Patients treated with NS-NSAIDs, but not celecoxib, experienced longer length of stay, higher incidence of peri-procedural myocardial infarction, and mildly increased post-PCI mortality (Table). These effects were unchanged after adjustment for age (p=0.001), ejection fraction (p<0.001), and history of previous MI (p<0.001). There was a trend towards lower long-term (50+/-15 months) mortality in NS-NSAIDs (9%) and celecoxib (6.7%) treated patients, when compared to the rest of the cohort (11.3%, Table). Conclusion: Non-selective NSAIDs, but not Celecoxib, are associated with prolonged hospital stay and increased peri-procedural myocardial infarction in PCI patients. Long-term mortality does not appear to be affected by the NSAIDs use at the time of PCI. Randomized studies of this important clinical question are needed.

Cardiac Surgery for Carcinoid Heart Disease: A Weapon Not to Be Misused

Cardiology ◽  
2016 ◽  
Vol 136 (4) ◽  
pp. 243-251 ◽  
Author(s):  
Maria Bonou ◽  
Chris J. Kapelios ◽  
Gregory Kaltsas ◽  
Konstantinos Perreas ◽  
Konstantinos Toutouzas ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Heart Disease ◽  
Treatment Options ◽  
Optimal Timing ◽  
Special Focus ◽  
Carcinoid Heart Disease ◽  
Term Survival ◽  
Patient Profile ◽  
Short And Long Term

Carcinoid heart disease (CHD) complicates approximately 25% of patients with a carcinoid tumor and carcinoid syndrome and leads to heart valve degeneration with mixed-stenotic and regurgitation pathology and consequent heart failure (HF) leading to significant morbidity and mortality. Cardiac surgery in symptomatic, severe CHD leads to significantly better functional capacity and prolonged survival when compared to medical treatment alone. Recent studies have shown improvement in postoperative outcomes of patients undergoing surgery for CHD over the last decades. The trend for early diagnosis and application of surgery prior to the manifestation of HF symptoms, which tended to develop during the previous years, does not seem justifiable based on the findings of recent studies. Therefore, the optimal timing of intervention in CHD and the type of valve that should preferably be used remain issues of controversy. This review comprehensively examines the existing literature on the treatment options for patients with CHD, with a special focus on short- and long-term survival after cardiac surgery, and discusses the selection of the exact patient profile and intervention timing that are more likely to optimize the benefit-to-risk ratio for surgical intervention.

scholarly journals Predictors of cardiovascular events in patients with chronic heart disease after surgical myocardial revascularization (according to the data of a long-term observation)

2010 ◽  
Vol 1 (1) ◽  
pp. 75-79
Author(s):  
S. V Shalayev ◽  
L. A Arutyunyan
Keyword(s):  
Myocardial Infarction ◽  
Mechanical Ventilation ◽  
Heart Disease ◽  
Coronary Artery ◽  
Cardiovascular Events ◽  
Artery Bypass ◽  
Myocardial Revascularization ◽  
Bypass Grafting ◽  
Chronic Heart Disease

Aim. To elucidate independent predictors of fatal and nonfatal cardiovascular events in patients with chronic heart disease (CHD) after surgical myocardial revascularization during a long-term prospective observation. Subjects and methods. The study enrolled 120 patients with CHD who had undergone coronary artery bypass grafting with extracorporeal circulation. Further 2-5-year follow-ups recorded deaths from cardiac causes, including sudden deaths, as well as the incidence of nonfatal cardiovascular events (myocardial infarction, stroke). Results. The mean follow-up time was 36±5 months. During the follow-ups, there were 12 deaths: 1 and 8 deaths from pneumonia and myocardial infarction, respectively; 3 patients died suddenly. Out of the nonfatal events, myocardial infarction and stroke were recorded in 7 and 2 cases, respectively. Stepwise regression analysis showed that the independent predictors of fatal cardiac events were as follows: 1) an ejection fraction of less than 40% (relative risk 5.7 with deviations within 95% confidence interval, 1,2–10,7); 2) age of 70 years or older (4,9; 1,4–8,4); 3) diabetes mellitus (2,3; 1,1–3,7); 4) left ventricular aneurysm (2,1; 1,04–3,8); 5) mechanical ventilation for more than 24 hours (2,0; 1,2–2,9); 6) chronic obstructive pulmonary disease (1,9; 1,1–3,1). The independent predictors of all cases of both fatal and nonfatal cardiovascular events were: 1) age of 70 years or older (4,1; 1,2–8,1); 2) an ejection fraction of less than 40% (3,7; 1,1–6,5); 3) endarterectomy during coronary artery bypass grafting (2,9; 1,1–5,4); 4) mechanical ventilation for more than 100 minutes (2,2; 1,2–3,9); damage to the brachiocephalic artery area (2,1; 1,1–6,4), prior stroke (1,8; 1,1–3,8). Conclusion. The conducted study indicated the implication of both the poor traditional predictors of CHD and comorbidity, as well as the specific features of surgical intervention and anesthetic maintenance in the development of further fatal and nonfatal cardiovascular events in patients with CHD after surgical myocardial revascularization.

scholarly journals Real-world evidence on short- and long-term outcomes for acute coronary syndrome patients with a prior history of atrial fibrillation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
P Gouda ◽  
A Savu ◽  
K Bainey ◽  
R Welsh ◽  
R.K Sandhu
Keyword(s):  
Myocardial Infarction ◽  
Hospital Mortality ◽  
Prior History ◽  
Long Term Outcomes ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
History Of ◽  
Short And Long Term

Abstract Background Acute coronary syndromes (ACS) are often complicated by new-onset atrial fibrillation (AF), which is associated with higher short-term mortality. It is unknown whether a prior history of AF affects outcomes beyond in-hospital mortality in a real-world setting. Purpose To assess (i) the prevalence of prior AF in patients with ACS, including unstable angina (UA), non-ST-segment elevation myocardial infarction (NSTEMI) and ST-segment elevation myocardial infarction (STEMI); (ii) clinical characteristics of ACS patients with and without AF; and (iii) in-hospital mortality and long-term outcomes in the presence of prior AF. Methods We used linked administrative health databases to identify patients hospitalized with a primary diagnosis of ACS and prior history of non-valvular AF (ICD-9 code 427.3 and ICD-10 code 148), which was defined as 1 hospitalization or 1 emergency department visit or 2 outpatient visits at least 30 days apart in 1 year in any position, between April 2002 and March 2016 in Alberta, Canada. Outcomes included in-hospital mortality, long-term mortality and a composite of all-cause mortality, hospitalisation for myocardial infarction (MI) or stroke over 3 years. Kaplan-Meier curves were constructed for mortality and the composite outcome according to presence of prior AF and ACS type. Results Of 31,056 presenting with an ACS, 4,173 (13.4%) had a prior history of AF. Compared to patients without prior AF, patients with AF were older (75.7 versus 64.7 years), female (35.5% versus 29.9%), with a higher comorbidity burden (Charlson Comorbidity Index 1.7 versus 1.1). Patient with AF more often presented with NSTEMI (57.7% versus 48.2%) and UA (17.1% versus 16.4%) compared to STEMI (25.2% versus 35.4%). In-hospital mortality was higher for ACS patients in the presence of prior AF (8.1% versus 3.3%; p&lt;0.0001). Mortality and the composite endpoint were also significantly higher in patients with prior AF compared to those without AF (Panel A and B) over the 3-year period. A worse prognosis was observed for STEMI and NSTEMI patients with prior AF compared to any other group (panel C and D). Conclusion In this large, population-based study, we found that a history of AF is common in patients presenting with an ACS. In the presence of AF, short- and long-term prognosis is poor particularly for STEMI and NSTEMI patients. Aggressive modification of shared risk factors and use of evidence-based therapies to improve outcomes is needed in this high-risk population. Outcomes by presence of AF and ACS type Funding Acknowledgement Type of funding source: None

scholarly journals Annuloplasty ring dehiscence after mitral valve repair: incidence, localization and reoperation

2019 ◽  
Author(s):  
Thilo Noack ◽  
Philipp Kiefer ◽  
Nina Vivell ◽  
Franz Sieg ◽  
Mateo Marin-Cuartas ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mortality Rate ◽  
Survival Rates ◽  
Clinical Problem ◽  
Valve Repair ◽  
Term Survival ◽  
Annuloplasty Ring ◽  
Ring Annuloplasty ◽  
Short And Long Term

Abstract OBJECTIVES Mitral valve (MV) annuloplasty ring dehiscence with subsequent recurrent mitral regurgitation represents an unusual but challenging clinical problem. Incidence, localization and outcomes for this complication have not been well defined. METHODS From 1996 to 2016, a total of 3478 patients underwent isolated MV repair with ring annuloplasty at the Leipzig Heart Centre. Of these patients, 57 (1.6%) underwent reoperation due to annuloplasty ring dehiscence. Echocardiographic data, operative and early postoperative characteristics as well as short- and long-term survival rates after MV reoperation were analysed. RESULTS Occurrences of ring dehiscence were acute (<30 days), early (≤1 year) and late (>1 year) in 44%, 33% and 23% of patients, respectively. Localization of annuloplasty ring dehiscence was found most frequently in the P3 segment (68%), followed by the P2 (51%) and the P1 segments (47%). The 30-day mortality rate and 1- and 5-year survival rates after MV reoperation were 2%, 89% and 74%, respectively. During reoperation, MV replacement was performed in 38 (67%) and MV re-repair in 19 (33%) patients. CONCLUSIONS Annuloplasty ring dehiscence is clinically less common, localized more frequently on the posterior annulus and occurs mostly acutely or early after MV repair. MV reoperation can be performed safely in such patients.

scholarly journals Long-Term Survival after Invasive or Conservative Strategy in Elderly Patients with non-ST-Elevation Myocardial Infarction: A Prospective Cohort Study

Cardiology ◽  
2019 ◽  
Vol 144 (3-4) ◽  
pp. 79-89 ◽  
Author(s):  
Kristin Marie Kvakkestad ◽  
Jon Michael Gran ◽  
Jan Eritsland ◽  
Charlotte Holst Hansen ◽  
Eigil Fossum ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Elderly Patients ◽  
Real Life ◽  
Term Survival ◽  
Long Term Survival ◽  
Conservative Strategy ◽  
Invasive Strategy ◽  
Conservative Group ◽  
Short And Long Term

Background: The optimal management of elderly patients with non-ST-segment elevation myocardial infarction (NSTEMI) is still discussed. We aimed to study short- and long-term survival in NSTEMI patients ≥75 years managed with an invasive or a conservative strategy. Methods: NSTEMI patients admitted to Oslo University Hospital Ulleval during 2005–2011 were included consecutively in a prospective registry. Vital status until December 31, 2013, was obtained from the Norwegian Cause of Death Registry. Patients ≥75 years were identified, and 30-day and 7-year survival were analyzed. Logistic- and Cox regression was used to estimate OR and hazard ratio (HR) for death in the invasive versus conservative group, adjusting for registered confounders. Results: There were 2,064 NSTEMI patients ≥75 years (48.2% women); 1,200 (58.1%) were treated with an invasive strategy, and were younger, more likely to be male and previously revascularized compared to 864 (41.9%) patients treated conservatively (p < 0.0001 for all). Survival at 30-day was 94.9% in the invasive and 76.6% in the conservative group. For 30-day survivors, 7-year survival was 47.4% (95% CI 42.9–51.8) and 11.6% (95% CI 8.3–15.6), respectively. After multivariate adjustment, an invasive strategy was associated with lower long-term risk (adjusted HR [aHR] 0.49 [95% CI 0.41–0.59]). Actual revascularization was associated with lower risk of long-term mortality compared to angiography only (aHRPCI 0.73 [95% CI 0.59–0.90], aHRCABG 0.43 [95% CI 0.28–0.65]). Conclusion: In this real-life cohort of NSTEMI patients ≥75 years, 30-day survival was 95%, and 7-year survival was 47% with an invasive strategy. Revascularized patients had a superior long-term prognosis. With a conservative strategy, short- and long-term survival was lower, probably due to selection bias and unmeasured confounding.

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