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Mortality pattern and cause of death in a long-term follow-up of patients with STEMI treated with primary PCI

OBJECTIVE: We aimed to assess the pattern of mortality and cause of death in a cohort of patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). METHODS: Consecutive patients with STEMI treated with primary PCI during 2006–2013...

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Autores principales: Doost Hosseiny, Ataollah, Moloi, Soniah, Chandrasekhar, Jaya, Farshid, Ahmad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4836287/
https://www.ncbi.nlm.nih.gov/pubmed/27099764
http://dx.doi.org/10.1136/openhrt-2016-000405
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author Doost Hosseiny, Ataollah
Moloi, Soniah
Chandrasekhar, Jaya
Farshid, Ahmad
author_facet Doost Hosseiny, Ataollah
Moloi, Soniah
Chandrasekhar, Jaya
Farshid, Ahmad
author_sort Doost Hosseiny, Ataollah
collection PubMed
description OBJECTIVE: We aimed to assess the pattern of mortality and cause of death in a cohort of patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). METHODS: Consecutive patients with STEMI treated with primary PCI during 2006–2013 were evaluated with a mean follow-up of 3.5 years (1–8.4 years). We used hospital and general practice records and mortality data from The Australian National Death Index. RESULTS: Among 1313 patients (22.5% female) with mean age of 62.3±13.1 years, 181 patients (13.7%) died during long-term follow-up. In the first 7 days, 45 patients (3.4%) died, 76% of these due to cardiogenic shock. Between 7 days and 1 year, another 50 patients died (3.9%), 58% from cardiovascular causes and 22% from cancer. Beyond 1 year, there were 86 deaths with an estimated mean mortality rate of 2.05% per year, 36% of deaths were cardiovascular and 52% non-cardiovascular, including 29% cancer-related deaths. On multivariate analysis, age ≥75 years, history of diabetes, prior PCI, cardiogenic shock, estimated glomerular filtration rate (eGFR) <60 and symptom-to-balloon time >360 min were independent predictors of long-term mortality. In 16 patients who died of sudden cardiac death postdischarge, only 4 (25%) had ejection fraction ≤35% and would have been eligible for an implantable cardioverter defibrillator. CONCLUSIONS: In the era of routine primary PCI, we found a mortality rate of 7.3% at 1 year, and 2.05% per year thereafter. Cause of death was predominantly cardiovascular in the first year and mainly non-cardiovascular after 1 year. Age, diabetes, prior PCI, cardiogenic shock, eGFR <60 and delayed treatment were independent predictors of mortality.
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spelling pubmed-48362872016-04-20 Mortality pattern and cause of death in a long-term follow-up of patients with STEMI treated with primary PCI Doost Hosseiny, Ataollah Moloi, Soniah Chandrasekhar, Jaya Farshid, Ahmad Open Heart Interventional Cardiology OBJECTIVE: We aimed to assess the pattern of mortality and cause of death in a cohort of patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). METHODS: Consecutive patients with STEMI treated with primary PCI during 2006–2013 were evaluated with a mean follow-up of 3.5 years (1–8.4 years). We used hospital and general practice records and mortality data from The Australian National Death Index. RESULTS: Among 1313 patients (22.5% female) with mean age of 62.3±13.1 years, 181 patients (13.7%) died during long-term follow-up. In the first 7 days, 45 patients (3.4%) died, 76% of these due to cardiogenic shock. Between 7 days and 1 year, another 50 patients died (3.9%), 58% from cardiovascular causes and 22% from cancer. Beyond 1 year, there were 86 deaths with an estimated mean mortality rate of 2.05% per year, 36% of deaths were cardiovascular and 52% non-cardiovascular, including 29% cancer-related deaths. On multivariate analysis, age ≥75 years, history of diabetes, prior PCI, cardiogenic shock, estimated glomerular filtration rate (eGFR) <60 and symptom-to-balloon time >360 min were independent predictors of long-term mortality. In 16 patients who died of sudden cardiac death postdischarge, only 4 (25%) had ejection fraction ≤35% and would have been eligible for an implantable cardioverter defibrillator. CONCLUSIONS: In the era of routine primary PCI, we found a mortality rate of 7.3% at 1 year, and 2.05% per year thereafter. Cause of death was predominantly cardiovascular in the first year and mainly non-cardiovascular after 1 year. Age, diabetes, prior PCI, cardiogenic shock, eGFR <60 and delayed treatment were independent predictors of mortality. BMJ Publishing Group 2016-04-15 /pmc/articles/PMC4836287/ /pubmed/27099764 http://dx.doi.org/10.1136/openhrt-2016-000405 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Interventional Cardiology
Doost Hosseiny, Ataollah
Moloi, Soniah
Chandrasekhar, Jaya
Farshid, Ahmad
Mortality pattern and cause of death in a long-term follow-up of patients with STEMI treated with primary PCI
title Mortality pattern and cause of death in a long-term follow-up of patients with STEMI treated with primary PCI
title_full Mortality pattern and cause of death in a long-term follow-up of patients with STEMI treated with primary PCI
title_fullStr Mortality pattern and cause of death in a long-term follow-up of patients with STEMI treated with primary PCI
title_full_unstemmed Mortality pattern and cause of death in a long-term follow-up of patients with STEMI treated with primary PCI
title_short Mortality pattern and cause of death in a long-term follow-up of patients with STEMI treated with primary PCI
title_sort mortality pattern and cause of death in a long-term follow-up of patients with stemi treated with primary pci
topic Interventional Cardiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4836287/
https://www.ncbi.nlm.nih.gov/pubmed/27099764
http://dx.doi.org/10.1136/openhrt-2016-000405
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