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Temporal Trends and Outcome of Patients with Acute Coronary Syndrome and Prior Myocardial Infarction

Patients who have previously had a myocardial infarction (MI) are considered a high-risk group with increased risk for cardiovascular (CV) events. During the last decade, the outcome of acute coronary syndrome (ACS) patients has improved due to advances in medical therapy and interventional techniqu...

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Autores principales: Orvin, Katia, Shechter, Alon, Zahger, Doron, Shklovski, Vitaly, Ovdat, Tal, Beigel, Roy, Kornowski, Ran, Eisen, Alon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8658674/
https://www.ncbi.nlm.nih.gov/pubmed/34884278
http://dx.doi.org/10.3390/jcm10235580
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author Orvin, Katia
Shechter, Alon
Zahger, Doron
Shklovski, Vitaly
Ovdat, Tal
Beigel, Roy
Kornowski, Ran
Eisen, Alon
author_facet Orvin, Katia
Shechter, Alon
Zahger, Doron
Shklovski, Vitaly
Ovdat, Tal
Beigel, Roy
Kornowski, Ran
Eisen, Alon
author_sort Orvin, Katia
collection PubMed
description Patients who have previously had a myocardial infarction (MI) are considered a high-risk group with increased risk for cardiovascular (CV) events. During the last decade, the outcome of acute coronary syndrome (ACS) patients has improved due to advances in medical therapy and interventional techniques. We aimed to examine temporal trends and outcomes of patients with prior MI admitted due to ACS from the Acute Coronary Syndrome Israeli Survey (ACSIS). Included were 16,934 ACS patients, of whom 31.4% had prior MI. For temporal trend analysis, the cohort was divided into an early period (2000–2008) and late period (2010–2018). For patients with prior MI, patients in the late period had a higher rate of CV risk factors and were treated more frequently with revascularization and guidelines-directed medical therapy. Recurrent MI (6.7% vs. 12%, p < 0.001), MACE (10.6% vs. 21%, p < 0.001) and 1-year mortality (10.7% vs. 14.6%, p < 0.001) were significantly lower in the late period. However, the mortality rate for patients with prior MI remained higher compared with patients without prior MI (10.7% vs. 6.8% p < 0.001) with an overall higher mortality rate in the STEMI group. Thus, despite significant improvement in outcome measures in the contemporary era, ACS patients with prior MI are still at increased risk for recurrent ischemic CV events and mortality.
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spelling pubmed-86586742021-12-10 Temporal Trends and Outcome of Patients with Acute Coronary Syndrome and Prior Myocardial Infarction Orvin, Katia Shechter, Alon Zahger, Doron Shklovski, Vitaly Ovdat, Tal Beigel, Roy Kornowski, Ran Eisen, Alon J Clin Med Article Patients who have previously had a myocardial infarction (MI) are considered a high-risk group with increased risk for cardiovascular (CV) events. During the last decade, the outcome of acute coronary syndrome (ACS) patients has improved due to advances in medical therapy and interventional techniques. We aimed to examine temporal trends and outcomes of patients with prior MI admitted due to ACS from the Acute Coronary Syndrome Israeli Survey (ACSIS). Included were 16,934 ACS patients, of whom 31.4% had prior MI. For temporal trend analysis, the cohort was divided into an early period (2000–2008) and late period (2010–2018). For patients with prior MI, patients in the late period had a higher rate of CV risk factors and were treated more frequently with revascularization and guidelines-directed medical therapy. Recurrent MI (6.7% vs. 12%, p < 0.001), MACE (10.6% vs. 21%, p < 0.001) and 1-year mortality (10.7% vs. 14.6%, p < 0.001) were significantly lower in the late period. However, the mortality rate for patients with prior MI remained higher compared with patients without prior MI (10.7% vs. 6.8% p < 0.001) with an overall higher mortality rate in the STEMI group. Thus, despite significant improvement in outcome measures in the contemporary era, ACS patients with prior MI are still at increased risk for recurrent ischemic CV events and mortality. MDPI 2021-11-27 /pmc/articles/PMC8658674/ /pubmed/34884278 http://dx.doi.org/10.3390/jcm10235580 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Orvin, Katia
Shechter, Alon
Zahger, Doron
Shklovski, Vitaly
Ovdat, Tal
Beigel, Roy
Kornowski, Ran
Eisen, Alon
Temporal Trends and Outcome of Patients with Acute Coronary Syndrome and Prior Myocardial Infarction
title Temporal Trends and Outcome of Patients with Acute Coronary Syndrome and Prior Myocardial Infarction
title_full Temporal Trends and Outcome of Patients with Acute Coronary Syndrome and Prior Myocardial Infarction
title_fullStr Temporal Trends and Outcome of Patients with Acute Coronary Syndrome and Prior Myocardial Infarction
title_full_unstemmed Temporal Trends and Outcome of Patients with Acute Coronary Syndrome and Prior Myocardial Infarction
title_short Temporal Trends and Outcome of Patients with Acute Coronary Syndrome and Prior Myocardial Infarction
title_sort temporal trends and outcome of patients with acute coronary syndrome and prior myocardial infarction
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8658674/
https://www.ncbi.nlm.nih.gov/pubmed/34884278
http://dx.doi.org/10.3390/jcm10235580
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