Incidence, Predictors, and Subsequent Mortality Risk of Recurrent Myocardial Infarction in Patients Following Discharge for Acute Myocardial Infarction
Open accessAbstract
BACKGROUND: In the percutaneous coronary intervention (PCI) era, little evidence exists regarding the incidence, predictors and long-term mortality of recurrent myocardial infarction (Re-MI) following discharge for acute myocardial infarction (AMI). METHODS AND RESULTS: A total of 7,870 patients who survived AMI were studied with a median follow-up period of 3.9 years: 353 patients (4.5%) experienced Re-MI, with 7 of those dying within 30 days, which was classified as fatal Re-MI. The incidence of Re-MI per year was 2.65% for the first year, and 0.91-1.42% thereafter up to 5 years. Multivariate Cox regression analyses revealed that predictors of Re-MI were diabetes mellitus (hazard ratio (HR): 2.079, P<0.001), history of MI (HR: 1.767, P=0.001), and advanced age (HR: 1.021, P=0.001). These 3 predictors remained significant when angiographic and procedural parameters were incorporated into the analyses. The incidence and adjusted risk of Re-MI increased when these variables were clustered (P<0.001). The all-cause mortality rate was significantly higher in patients with Re-MI than in those without (HR: 2.206, P<0.001). CONCLUSIONS: In post-AMI patients treated in the PCI era, the incidence of Re-MI is low compared with that reported during the past 30 years. Patients' clinical factors of diabetes mellitus, history of MI, and advanced age appear to affect the occurrence of Re-MI after hospital discharge, and Re-MI still carries a risk for subsequent mortality.
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In the CTT study, decreasing LDL-C level by 38.7 mg/dL using statins decreases cerebrovascular disease risk in DM patients by 21%.
“In the CTT study, it was reported that decreasing LDL-C level by 38.7 mg/dL using statins, cerebrovascular disease risk in DM patients is decreased by 21%.”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [838]
It is likely that control of LDL-C is effective for the prevention of cerebrovascular disease same as CAD prevention.
“Thus, it is likely that control of LDL-C is effective for the prevention of cerebrovascular disease same as CAD prevention838).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [838]
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- Authors
- Nakatani, D., Sakata, Y., Suna, S., Usami, M., Matsumoto, S., Shimizu, M., Sumitsuji, S., Kawano, S., Ueda, Y., Hamasaki, T., Sato, H., Nanto, S., Hori, M., Komuro, I., & for the Osaka Acute Coronary Insufficiency Study (OACIS) Investigators
- Affiliations
- The University of Osaka (JP)
- Tohoku University (JP)
- Kawachi General Hospital (JP)
- Osaka Police Hospital (JP)
- Kwansei Gakuin University (JP)
- Osaka International Cancer Institute (JP)
- ORCID
- Venue
- Circulation Journal
- Publisher
- Japanese Circulation Society
- Published
- 2013
- Volume
- 77
- Issue
- 2
- Pages
- 439-446
- ISSN
- 1346-9843 (ISSN-L)
- 1347-4820
- OpenAlex
- W2032654380
- Cited by
- 108
- References
- 40
- Citations by year
- 2026: 4 · 2024: 6 · 2023: 7 · 2022: 7 · 2021: 12 · 2020: 9 · 2019: 11 · 2018: 11 · 2017: 9 · 2016: 11 · 2015: 13 · 2014: 5 · 2013: 3
- FWCI
- 7.24
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- Circulation Journal (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ministry of Education, Culture, Sports, Science and Technology (#19590816, 19390215)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Health Sciences › Medicine › Surgery › Coronary Interventions and Diagnostics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- reinfarction, acute myocardial infarction, percutaneous coronary intervention, incidence, risk factors, diabetes mellitus, history of myocardial infarction, old age, all-cause mortality, post-discharge follow-up
- MeSH terms
- Aged, Diabetes Mellitus, Female, Follow-Up Studies, Humans, Male, Middle Aged, Myocardial Infarction, Patient Discharge, Predictive Value of Tests, Prognosis, Prospective Studies, Registries, Risk Factors, Incidence, Proportional Hazards Models, Kaplan-Meier Estimate, Acute Coronary Syndrome
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