scholarly journals Association of Maximum Troponin Levels With Diagnosis of Acute Myocardial Infarction and Elevated Risk of Mortality

2021 ◽  
Vol 21 (3) ◽  
pp. 261-266
Author(s):  
Jerry Fan ◽  
Kendall Hammonds ◽  
Bright Izekor ◽  
Clinton Jones ◽  
Patrick McGrade ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Elevated Risk ◽  
Risk Of Mortality

scholarly journals Sociodemographic, labour market marginalisation and medical characteristics as risk factors for reinfarction and mortality within 1 year after a first acute myocardial infarction: a register-based cohort study of a working age population in Sweden

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e033616
Author(s):  
Mo Wang ◽  
Marjan Vaez ◽  
Thomas Ernst Dorner ◽  
Syed Ghulam Rahman ◽  
Magnus Helgesson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cohort Study ◽  
Labour Market ◽  
Work Disability ◽  
First Year ◽  
Risk Of Mortality ◽  
All Cause Mortality

ObjectivesResearch covering a wide range of risk factors related to the prognosis during the first year after an acute myocardial infarction (AMI) is insufficient. This study aimed to investigate whether sociodemographic, labour market marginalisation and medical characteristics before/at AMI were associated with subsequent reinfarction and all-cause mortality.DesignPopulation-based cohort study.ParticipantsThe cohort included 15 069 individuals aged 25–64 years who had a first AMI during 2008–2010.Primary and secondary outcome measuresThe outcome measures consisted of reinfarction and all-cause mortality within 1 year following an AMI, which were estimated by univariate and multivariable HRs and 95% CIs by Cox regression.ResultsSociodemographic characteristics such as lower education showed a 1.1-fold and 1.3-fold higher risk for reinfarction and mortality, respectively. Older age was associated with a higher risk of mortality while being born in non-European countries showed a lower risk of mortality. Labour market marginalisation such as previous long-term work disability was associated with a twofold higher risk of mortality. Regarding medical characteristics, ST-elevation myocardial infarction was predictive for reinfarction (HR: 1.14, 95% CI: 1.07 to 1.21) and all-cause mortality (HR: 3.80, 95% CI: 3.08 to 4.68). Moreover, diabetes mellitus, renal insufficiency, stroke, cancer and mental disorders were associated with a higher risk of mortality (range of HRs: 1.24–2.59).ConclusionsSociodemographic and medical risk factors were identified as risk factors for mortality and reinfarction after AMI, including older age, immigration status, somatic and mental comorbidities. Previous long-term work disability and infarction type provide useful information for predicting adverse outcomes after AMI during the first year, particularly for mortality.

Development and validation of a claims based index for adjusting for risk of mortality: The case of acute myocardial infarction

1995 ◽  
Vol 48 (2) ◽  
pp. 229-243 ◽  
Author(s):  
Sharon-Lise T. Normand ◽  
Carl N. Morris ◽  
Karen S. Fung ◽  
Barbara J. McNeil ◽  
Arnold M. Epstein
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Risk Of Mortality ◽  
Development And Validation

scholarly journals Treatment-resistant and insufficiently treated depression and all-cause mortality following myocardial infarction

2012 ◽  
Vol 200 (2) ◽  
pp. 137-142 ◽  
Author(s):  
Jeffrey F. Scherrer ◽  
Timothy Chrusciel ◽  
Lauren D. Garfield ◽  
Kenneth E. Freedland ◽  
Robert M. Carney ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Service Utilisation ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Major Depressive ◽  
Risk Of Mortality ◽  
All Cause Mortality ◽  
Resistant Depression

BackgroundDepression is a known risk factor for mortality after an acute myocardial infarction. Patients with treatment-responsive depression may have a better prognosis than those with treatment-resistant depression.AimsWe sought to determine whether mortality following acute myocardial infarction was associated with treatment-resistant depression.MethodFollow-up began after myocardial infarction and continued until death or censorship. Depression was counted as present if diagnosed any time during the study period. Treatment for depression was defined as receipt of 12 or more weeks of continuous antidepressant therapy at a therapeutic dose during follow-up. Treatment-resistant depression was defined as use of two or more antidepressants plus augmentation therapy, receipt of electroconvulsive therapy or use of monoamine oxidase inhibitors. Mean duration of follow-up was 39 months.ResultsDuring follow-up of 4037 patients with major depressive disorder who had had a myocardial infarction, 6.9% of those with insufficiently treated depression, 2.4% of those with treated depression and 5.0% of those with treatment-resistant depression died. A multivariable survival model that adjusted for sociodemographics, anxiety disorders, beta-blocker use, mortality risk factors and health service utilisation indicated that compared with treated patients, insufficiently treated patients were 3.04 (95% CI 2.12–4.35) times more likely and patients with treatment-resistant depression were 1.71 (95% CI 1.05–2.79) times more likely to die.ConclusionsAll-cause mortality following an acute myocardial infarction is greatest in patients with depression who are insufficiently treated and is a risk in patients with treatment-resistant depression. However, the risk of mortality associated with treatment-resistant depression is partly explained by comorbid disorders. Further studies are warranted to determine whether changes in depression independently predict all-cause mortality.

scholarly journals Acute myocardial infarction associated with abacavir and tenofovir based antiretroviral drug combinations in the United States

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Kunchok Dorjee ◽  
Manisha Desai ◽  
Tsering Choden ◽  
Sanjiv M. Baxi ◽  
Alan E. Hubbard ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
The United States ◽  
Antiretroviral Drugs ◽  
Elevated Risk ◽  
Drug Combinations ◽  
Cvd Risk ◽  
Antiretroviral Drug ◽  
Increased Risk ◽  
Current Exposure

Abstract Introduction Although individual antiretroviral drugs have been shown to be associated with elevated cardiovascular disease (CVD) risk, data are limited on the role of antiretroviral drug combinations. Therefore, we sought to investigate CVD risk associated with antiretroviral drug combinations. Methods Using an administrative health-plan dataset, risk of acute myocardial infarction (AMI) associated with current exposure to antiretroviral drug combinations was assessed among persons living with HIV receiving antiretroviral therapy (ART) across the U.S. from October 2009 through December 2014. To account for confounding-by-indication and for factors simultaneously acting as causal mediators and confounders, we applied inverse probability of treatment weighted marginal structural models to longitudinal data of patients. Results Over 114,417 person-years (n = 73,071 persons) of ART exposure, 602 cases of AMI occurred at an event rate of 5.26 (95% CI: 4.86, 5.70)/1000 person-years. Of the 14 antiretroviral drug combinations studied, persons taking abacavir-lamivudine-darunavir had the highest incidence rate (IR: 11/1000; 95% CI: 7.4–16.0) of AMI. Risk (HR; 95% CI) of AMI was elevated for current exposure to abacavir-lamivudine-darunavir (1.91; 1.27–2.88), abacavir-lamivudine-atazanavir (1.58; 1.08–2.31), and tenofovir-emtricitabine-raltegravir (1.35; 1.07–1.71). Tenofovir-emtricitabine-efavirenz was associated with reduced risk (0.65; 0.54–0.78). Abacavir-lamivudine-darunavir was associated with increased risk of AMI beyond that expected of abacavir alone, likely attributable to darunavir co-administration. We did not find an elevated risk of AMI when abacavir-lamivudine was combined with efavirenz or raltegravir. Conclusion The antiretroviral drug combinations abacavir-lamivudine-darunavir, abacavir-lamivudine-atazanavir and tenofovir-emtricitabine-raltegravir were found to be associated with elevated risk of AMI, while tenofovir-emtricitabine-efavirenz was associated with a lower risk. The AMI risk associated with abacavir-lamivudine-darunavir was greater than what was previously described for abacavir, which could suggest an added risk from darunavir. The results should be confirmed in additional studies.

Potassium Fluctuations Are Associated With Inhospital Mortality From Acute Myocardial Infarction. Soroka Acute Myocardial Infarction II (SAMI-II) Project

Angiology ◽  
2017 ◽  
Vol 69 (8) ◽  
pp. 709-717 ◽  
Author(s):  
Arthur Shiyovich ◽  
Harel Gilutz ◽  
Ygal Plakht
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Primary Outcome ◽  
Medical Center ◽  
Inhospital Mortality ◽  
St Segment Elevation ◽  
Risk Of Mortality ◽  
St Segment ◽  
Increased Risk ◽  
All Cause Mortality

Potassium levels (K, mEq/L) fluctuate in patients with acute myocardial infarction (AMI). Potassium was reported to be associated with prognosis in patients with AMI; however, studies evaluating the prognostic value of K fluctuations in this setting are scarce. We retrospectively analyzed patients with AMI hospitalized in a tertiary medical center, through 2002 to 2012. Patients on chronic dialysis or mechanical ventilation were excluded. Based on all K values during hospitalization, minimal, maximal, and fluctuation (gap between 2 consecutive K) were recorded. Primary outcome was inhospital all-cause mortality. Overall, 10 032 patients were studied (age 68.1 ± 14.3 years, 65.4% males, 44.2% ST-segment elevation MI), of which 507 (3.7%) died in hospital. Potassium decreased during the first 2 to 3 days ( P for trend <.001), followed by stabilization ( P for trend = .807). Potassium in the extreme categories (<3.8 and ≥4.7) and absolute fluctuations >0.1 mEq/L were more common among nonsurvivors than survivors ( P < .001 each). In a multivariate analysis, combinations of minimal K <3.8 with maximal K ≥4.7 (odds ratio [OR] = 18.1), K ≥4.4 with fluctuation ≥0.1 (OR = 1.74), or <−0.1 (OR = 2.6) and minimal K after the first 2 admission days (OR = 2.07) were associated with increased risk of mortality ( P < .001 each). Potassium fluctuations, peak and nadir K, and its timing independently predict inhospital mortality in patients with AMI.

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