scholarly journals Association between off-hours admission and short-term and long-term mortality in acute myocardial infarction: a meta-analysis and meta-regression

2020 ◽  
Author(s):  
Xiao-Ce Dai ◽  
Lan Ma ◽  
Yun-Tao Zhao ◽  
Wan-Jie Gu ◽  
Ying Dai
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Meta Analysis ◽  
Short Term ◽  
Meta Regression ◽  
Long Term Mortality

scholarly journals Association Between Out-of-Hour Admission and Short- and Long-Term Mortality in Acute Myocardial Infarction: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Yue-Yan Yu ◽  
Bo-Wen Zhao ◽  
Lan Ma ◽  
Xiao-Ce Dai
Keyword(s):  
Myocardial Infarction ◽  
Systematic Review ◽  
Acute Myocardial Infarction ◽  
Publication Bias ◽  
Meta Analysis ◽  
Short Term ◽  
Short Term Mortality ◽  
Short And Long Term ◽  
Long Term Mortality

Objectives: Out-of-hour admission (on weekends, holidays, and weekday nights) has been associated with higher mortality in patients with acute myocardial infarction (AMI). We conducted a meta-analysis to verify the association between out-of-hour admission and mortality (both short- and long-term) in AMI patients.Design: This Systematic review and meta-analysis of cohort studies.Data Sources: PubMed and EMBASE were searched from inception to 27 May 2021.Eligibility Criteria for Selected Studies: Studies of any design examined the potential association between out-of-hour admission and mortality in AMI.Data Extraction and Synthesis: In total, 2 investigators extracted the data and evaluated the risk of bias. Analysis was conducted using a random-effects model. The results are shown as odds ratios [ORs] with 95% confidence intervals (CIs). I2 value was used to estimate heterogeneity. Grading of Recommendations Assessment, Development, and Evaluation was used to assess the certainty of the evidence.Results: The final analysis included 45 articles and 15,346,544 patients. Short-term mortality (defined as either in-hospital or 30-day mortality) was reported in 42 articles (15,340,220 patients). Out-of-hour admission was associated with higher short-term mortality (OR 1.04; 95%CI 1.02–1.05; I2 = 69.2%) but there was a significant statistical indication for publication bias (modified Macaskill's test P < 0.001). One-year mortality was reported in 10 articles (1,386,837 patients). Out-of-hour admission was also associated with significantly increased long-term mortality (OR 1.03; 95%CI 1.01–1.04; I2 = 66.6%), with no statistical indication of publication bias (p = 0.207). In the exploratory subgroup analysis, the intervention effect for short-term mortality was pronounced among patients in different regions (p = 0.04 for interaction) and socio-economic levels (p = 0.007 for interaction) and long-term mortality was pronounced among patients with different type of AMI (p = 0.0008 for interaction) or on different types of out-to-hour admission (p = 0.006 for interaction).Conclusion: Out-of-hour admission may be associated with an increased risk of both short- and long-term mortality in AMI patients.Trial Registration: PROSPERO (CRD42020182364).

Efficacy and Safety of Adjunctive Trimetazidine Therapy for Acute Myocardial Infarction: A Systematic Review and Meta-Analysis

Cardiology ◽  
2016 ◽  
Vol 135 (3) ◽  
pp. 188-195 ◽  
Author(s):  
Yongyong Li ◽  
Dewei Wang ◽  
Chunxiao Hu ◽  
Peng Zhang ◽  
Dongying Zhang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Systematic Review ◽  
Acute Myocardial Infarction ◽  
Adverse Events ◽  
Meta Analysis ◽  
Efficacy And Safety ◽  
Short Term ◽  
All Cause Mortality ◽  
Acute Mi

Background: Several lines of evidence support the clinical use of trimetazidine as an adjunctive therapy in cardioischemic patients. Therefore, we assessed here the efficacy and safety of adjunctive trimetazidine therapy in acute myocardial infarction (MI) patients by a systematic review and meta-analysis of the current literature. Methods: PubMed, the Cochrane Library, and the China National Knowledge Infrastructure databases were searched for clinical studies comparing adjunctive trimetazidine therapy against placebo in adult acute MI patients. Several clinical outcomes [early/short-term all-cause mortality, long-term all-cause mortality, total major adverse cardiac events (MACE), recurrent nonfatal MI, in-hospital adverse events, target vessel revascularization (TVR), and coronary artery bypass graft (CABG)] were analyzed by the intention-to-treat principle. Odds ratios (OR) and their 95% confidence intervals (CI) were derived from the number of outcome events in each study arm to estimate the association between adjuvant trimetazidine administration and the various clinical outcomes. A random-effects model was applied for all meta-analyses. Results: We found that adjunctive trimetazidine therapy showed a significant effect upon total MACE (OR = 0.33, 95% CI = 0.15-0.74; p = 0.007) but showed no significant effect upon early/short-term all-cause mortality, long-term all-cause mortality, recurrent nonfatal MI, in-hospital adverse events, TVR, or CABG (p > 0.05). Conclusions: This is the first meta-analysis to report that adjunctive trimetazidine therapy has a beneficial effect upon total MACE in acute MI patients. Clinical investigators should consider further trials on adjunctive trimetazidine therapy in order to better define its risks and benefits in acute MI patients.

Body mass index linked to short-term and long-term all-cause mortality in patients with acute myocardial infarction

2021 ◽  
pp. postgradmedj-2020-139677
Author(s):  
Rui Yang ◽  
Wen Ma ◽  
Zi-Chen Wang ◽  
Tao Huang ◽  
Feng-Shuo Xu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Body Mass Index ◽  
Intensive Care ◽  
Body Mass ◽  
Normal Weight ◽  
Short Term ◽  
Icu Patients ◽  
Long Term Mortality

Purposes of studyThis study aimed to elucidate the relationship between obesity and short-term and long-term mortality in patients with acute myocardial infarction (AMI) by analysing the body mass index (BMI).Study designA retrospective cohort study was performed on adult intensive care unit (ICU) patients with AMI in the Medical Information Mart for Intensive Care III database. The WHO BMI classification was used in the study. The Kaplan-Meier curve was used to show the likelihood of survival in patients with AMI. The relationships of the BMI classification with short-term and long-term mortality were assessed using Cox proportional hazard regression models.ResultsThis study included 1295 ICU patients with AMI, who were divided into four groups according to the WHO BMI classification. Our results suggest that obese patients with AMI tended to be younger (p<0.001), be men (p=0.001) and have higher blood glucose and creatine kinase (p<0.001) compared with normal weight patients. In the adjusted model, compared with normal weight AMI patients, those who were overweight and obese had lower ICU risks of death HR=0.64 (95% CI 0.46 to 0.89) and 0.55 (0.38 to 0.78), respectively, inhospital risks of death (0.77 (0.56 to 1.09) and 0.61 (0.43 to 0.87)) and long-term risks of death (0.78 0.64 to 0.94) and 0.72 (0.59 to 0.89). On the other hand, underweight patients had higher risks of short-term(ICU or inhospital mortality) and long-term mortality compared with normal weight patients (HR=1.39 (95% CI 0.58 to 3.30), 1.46 (0.62 to 3.42) and 1.99 (1.15 to 3.44), respectively).ConclusionsOverweight and obesity were protective factors for the short-term and long-term risks of death in patients with AMI.

scholarly journals Absence of chest pain and long-term mortality in patients with acute myocardial infarction

Open Heart ◽  
2018 ◽  
Vol 5 (2) ◽  
pp. e000909 ◽  
Author(s):  
Lena Björck ◽  
Susanne Nielsen ◽  
Tomas Jernberg ◽  
Tatiana Zverkova-Sandström ◽  
Kok Wai Giang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Multivariable Analysis ◽  
Mortality Rates ◽  
Symptom Presentation ◽  
Short Term ◽  
Predominant Symptom ◽  
Long Term Mortality

ObjectiveChest pain is the predominant symptom in patients with acute myocardial infarction (AMI). A lack of chest pain in patients with AMI is associated with higher in-hospital mortality, but whether this outcome is sustained throughout the first years after onset is unknown. Therefore, we aimed to investigate long-term mortality in patients hospitalised with AMI presenting with or without chest pain.MethodsAll AMI cases registered in the SWEDEHEART registry between 1996 and 2010 were included in the study. In total, we included 172 981 patients (33.5% women) with information on symptom presentation.ResultsPatients presenting without chest pain (12.7%) were older, more often women and had more comorbidities, prior medications and complications during hospitalisation than patients with chest pain. Short-term and long-term mortality rates were higher in patients without chest pain than in patients with chest pain: 30-day mortality, 945 versus 236/1000 person-years; 5-year mortality, 83 versus 21/1000 person-years in patients <65 years. In patients ≥65 years, 30-day mortality was 2294 versus 1140/1000 person-years; 5-year mortality, 259 versus 109/1000 person-years. In multivariable analysis, presenting without chest pain was associated with an overall 5-year HR of 1.85 (95% CI 1.81 to 1.89), with a stronger effect in younger compared with older patients, as well as in patients without prior AMI, heart failure, stroke, diabetes or hypertension.ConclusionAbsence of chest pain in patients with AMI is associated with more complications and higher short-term and long-term mortality rates, particularly in younger patients, and in those without previous cardiovascular disease.

scholarly journals Prognostic value of new-onset right bundle-branch block in acute myocardial infarction patients: a systematic review and meta-analysis

PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e4497 ◽  
Author(s):  
Juntao Wang ◽  
Hongxing Luo ◽  
Chunling Kong ◽  
Shujuan Dong ◽  
Jingchao Li ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Lower Risk ◽  
Prognostic Value ◽  
Meta Analysis ◽  
Short Term ◽  
Bundle Branch Block ◽  
Short Term Mortality ◽  
Long Term Mortality ◽  
New Onset

Background Patients with acute myocardial infarction (AMI) and bundle-branch block have poor prognoses. The new European Society of Cardiology guideline suggests a primary percutaneous coronary intervention strategy when persistent ischemic symptoms occur in patients with persistent ischemic symptoms and right bundle-branch block (RBBB), but the level of evidence is not high. In fact, the presence of RBBB may lead to the misdiagnosis of transmural ischemia and mask the early diagnosis of ST-elevation myocardial infarction. Moreover, new-onset RBBB is occasionally caused by AMI. Our study aims to investigate the prognostic value of new-onset RBBB in AMI. Methods and Results We conducted a meta-analysis of studies to evaluate the prognostic value of RBBB in AMI patients. Of 914 primary records, five studies and 874 MI patients were included for meta-analysis. Compared with previous RBBB, AMI patients with new-onset RBBB had a higher risk of long-term mortality (RR, 1.66, 95% CI [1.31–2.09], I2 = 0.0%, p = 0.000, n = 2), ventricular arrhythmia (RR, 4.86, 95% CI [2.10–11.27], I2 = 0.0%, p = 0.000, n = 3), and cardiogenic shock (RR, 2.76, 95% CI [1.66–4.59], I2 = 0.0%, p = 0.000, n = 3), but a lower risk of heart failure (RR, 0.66, 95% CI [0.52–0.85], I2 = 2.50%, p = 0.001, n = 4). Compared with AMI patients with new-onset permanent RBBB, patients with new-onset transient RBBB had a lower risk of short-term mortality (RR, 0.20, 95% CI [0.11–0.37], I2 = 44.1%, p = 0.000, n = 4). Conclusion New-onset RBBB is likely to increase long-term mortality, ventricular arrhythmia, and cardiogenic shock, but not heart failure in AMI patients. AMI patients with new-onset transient RBBB have a lower risk of short-term mortality than those with new-onset permanent RBBB. Revascularization therapies should be considered when persistent ischemic symptoms occur in patients with RBBB, especially new-onset RBBB.

scholarly journals Effects of mechanical circulatory support devices in patients with acute myocardial infarction undergoing stent implantation: a systematic review and meta-analysis of randomised controlled trials

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e044072
Author(s):  
Yunmin Shi ◽  
Yujie Wang ◽  
Xuejing Sun ◽  
Yan Tang ◽  
Mengqing Jiang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Systematic Review ◽  
Acute Myocardial Infarction ◽  
Clinical Outcomes ◽  
Stent Implantation ◽  
Mechanical Circulatory Support ◽  
Meta Analysis ◽  
Circulatory Support ◽  
Short Term

ObjectiveThe survival benefit of using mechanical circulatory support (MCS) in patients with acute myocardial infarction (AMI) is still controversial. It is necessary to explore the impact on clinical outcomes of MCS in patients with AMI undergoing stenting.DesignSystematic review and meta-analysis.Data sourcesEmbase, Cochrane Library, Medline, PubMed, Web of Science, ClinicalTrials.gov and Clinicaltrialsregister.eu databases were searched from database inception to February 2021.Eligibility criteriaRandomised clinical trials (RCTs) on MCS use in patients with AMI undergoing stent implantation were included.Data extraction and synthesisData were extracted and summarised independently by two reviewers. Risk ratios (RRs) and 95% CIs were calculated for clinical outcomes according to random-effects model.ResultsTwelve studies of 1497 patients with AMI were included, nine studies including 1382 patients compared MCS with non-MCS, and three studies including 115 patients compared percutaneous ventricular assist devices (pVADs) versus intra-aortic balloon pump (IABP). Compared with non-MCS, MCS was not associated with short-term (within 30 days) (RR=0.90; 95% CI 0.57 to 1.41; I2=46.8%) and long-term (at least 6 months) (RR=0.82; 95% CI 0.57 to 1.17; I2=37.6%) mortality reductions. In the subset of patients without cardiogenic shock (CS) compared with non-MCS, the patients with IABP treatment significantly had decreased long-term mortality (RR=0.49; 95% CI 0.27 to 0.90; I2=0), but without the short-term mortality reductions (RR=0.51; 95% CI 0.22 to 1.19; I2=17.9%). While in the patients with CS, the patients with MCS did not benefit from the short-term (RR=1.09; 95% CI 0.67 to 1.79; I2=46.6%) or long-term (RR=1.00; 95% CI 0.75 to 1.33; I2=22.1%) survival. Moreover, the application of pVADs increased risk of bleeding (RR=1.86; 95% CI 1.15 to 3.00; I2=15.3%) compared with IABP treatment (RR=1.86; 95% CI 1.15 to 3.00; I2=15.3%).ConclusionsIn all patients with AMI undergoing stent implantation, the MCS use does not reduce all-cause mortality. Patients without CS can benefit from MCS regarding long-term survival, while patients with CS seem not.

Sign in / Sign up

Export Citation Format

Share Document