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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...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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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. |
format | Online Article Text |
id | pubmed-8658674 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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