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When More Means Less: The Prognosis of Recurrent Acute Myocardial Infarctions

Recurrent acute myocardial infarctions (AMI) are common and associated with dismal outcomes. We evaluated the clinical characteristics and the prognosis of AMI survivors according to the number of recurrent AMIs (ReAMI) and the time interval of events (TI). A retrospective analysis of patients who s...

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Autores principales: Plakht, Ygal, Gilutz, Harel, Shiyovich, Arthur
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8706169/
https://www.ncbi.nlm.nih.gov/pubmed/34945184
http://dx.doi.org/10.3390/jcm10245889
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author Plakht, Ygal
Gilutz, Harel
Shiyovich, Arthur
author_facet Plakht, Ygal
Gilutz, Harel
Shiyovich, Arthur
author_sort Plakht, Ygal
collection PubMed
description Recurrent acute myocardial infarctions (AMI) are common and associated with dismal outcomes. We evaluated the clinical characteristics and the prognosis of AMI survivors according to the number of recurrent AMIs (ReAMI) and the time interval of events (TI). A retrospective analysis of patients who survived following hospitalization with an AMI throughout 2002–2017 was conducted. The number of ReAMIs for each patient during the study period was recorded and classified based on following: 0 (no ReAMIs), 1, 2, ≥3. Primary outcome: all-cause mortality up to 10 years post-discharge from the last AMI. A total of 12,297 patients (15,697 AMI admissions) were analyzed (age: 66.1 ± 14.1 years, 68% males). The mean number of AMIs per patient was 1.28 ± 0.7; the rates of 0, 1, 2, ≥3 ReAMIs were 81%, 13.4%, 3.6% and 1.9%, respectively. The risk of mortality increased in patients with greater number of AMIs, HR = 1.666 (95% CI: 1.603–1.720, p < 0.001) for each additional event (study group), attenuated following adjustment for potential confounders, AdjHR = 1.135 (95% CI: 1.091–1.181, p < 0.001). Increased risk of mortality was found with short TI (<6-months), AdjHR = 2.205 (95% CI: 1.418–3.429, p < 0.001). The risk of mortality following AMI increased as the number of ReAMIs increased, and the TI between the events shortened. These findings should guide improved surveillance and management of this high-risk group of patients (i.e., ReAMI).
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spelling pubmed-87061692021-12-25 When More Means Less: The Prognosis of Recurrent Acute Myocardial Infarctions Plakht, Ygal Gilutz, Harel Shiyovich, Arthur J Clin Med Article Recurrent acute myocardial infarctions (AMI) are common and associated with dismal outcomes. We evaluated the clinical characteristics and the prognosis of AMI survivors according to the number of recurrent AMIs (ReAMI) and the time interval of events (TI). A retrospective analysis of patients who survived following hospitalization with an AMI throughout 2002–2017 was conducted. The number of ReAMIs for each patient during the study period was recorded and classified based on following: 0 (no ReAMIs), 1, 2, ≥3. Primary outcome: all-cause mortality up to 10 years post-discharge from the last AMI. A total of 12,297 patients (15,697 AMI admissions) were analyzed (age: 66.1 ± 14.1 years, 68% males). The mean number of AMIs per patient was 1.28 ± 0.7; the rates of 0, 1, 2, ≥3 ReAMIs were 81%, 13.4%, 3.6% and 1.9%, respectively. The risk of mortality increased in patients with greater number of AMIs, HR = 1.666 (95% CI: 1.603–1.720, p < 0.001) for each additional event (study group), attenuated following adjustment for potential confounders, AdjHR = 1.135 (95% CI: 1.091–1.181, p < 0.001). Increased risk of mortality was found with short TI (<6-months), AdjHR = 2.205 (95% CI: 1.418–3.429, p < 0.001). The risk of mortality following AMI increased as the number of ReAMIs increased, and the TI between the events shortened. These findings should guide improved surveillance and management of this high-risk group of patients (i.e., ReAMI). MDPI 2021-12-15 /pmc/articles/PMC8706169/ /pubmed/34945184 http://dx.doi.org/10.3390/jcm10245889 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
Plakht, Ygal
Gilutz, Harel
Shiyovich, Arthur
When More Means Less: The Prognosis of Recurrent Acute Myocardial Infarctions
title When More Means Less: The Prognosis of Recurrent Acute Myocardial Infarctions
title_full When More Means Less: The Prognosis of Recurrent Acute Myocardial Infarctions
title_fullStr When More Means Less: The Prognosis of Recurrent Acute Myocardial Infarctions
title_full_unstemmed When More Means Less: The Prognosis of Recurrent Acute Myocardial Infarctions
title_short When More Means Less: The Prognosis of Recurrent Acute Myocardial Infarctions
title_sort when more means less: the prognosis of recurrent acute myocardial infarctions
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8706169/
https://www.ncbi.nlm.nih.gov/pubmed/34945184
http://dx.doi.org/10.3390/jcm10245889
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