Temporal Trends in Acute Myocardial Infarction: What about Survival of Hospital Survivors?

Arthur Shiyovich 3 Harel Gilutz 1 Ygal Plakht 2
1Cardiology, Soroka University Medical Center, Beer Sheva, Israel
2Unit of Nursing research, Soroka University Medical Center, Beer Sheva, Israel
3Medicine E, Rabin Medical Center, Petach Tikwa, Israel

Background: The study explored trends in acute myocardial infarction (AMI) hospitalizations and one-year all-cause post-discharge mortality (OM) considering changes in the risk profile (RP) of hospital survivors (HS).

Methods: a retrospective analysis of 11,108 consecutive AMI patients in a tertiary medical center in southern Negev (Israel) throughout 2002-2012. The annual incidence of AMI was calculated using a direct adjustment for age, sex and ethnicity. A multivariate prognostic model was built for each year in order to evaluate OM adjusted for a RP of the patients.

Results: A decrease in the adjusted incidence of AMI [4.2/1000 (2002) vs. 2.6/1000 (2012)]; and in-hospital mortality [9.1% (2002) vs. 6.4% (2012)] were observed (p-for-trend<0.001, each). However, OM among hospital survivors maintained at ~13% (p=0.4). An improvement in the RP (i.e. decrease of prevalence of most risk factors and increase of invasive treatments) of HS was found across the years; however the strength of the association of these factors with OM did not change. Adjustment of temporal changes in OM to changes in patients’ RP resulted in a significant increase throughout the years [AdjOR=1.12 per year (95% CI: 1.09-1.14), p<0.001].

Conclusions: throughout 2002-2012 significant improvement in the incidence, in-hospital mortality and RP of HS were found. However, OM increased considering the improved RP. Measures for improving prognosis of AMI HS of should be established.

 

 Adjusted incidence of AMI hospitalizations and the relative risk (adjusted odds ratio) for one-year-post discharge- mortality throughout 2002-2012 - temporal trends.

 









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