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Long-term outcome and risk assessment in premature acute myocardial infarction: A 10-year follow-up study.

Abstract：

BACKGROUND:Premature acute myocardial infarction (AMI) is a rare disease carrying significant morbidity and mortality. Existing data on outcome in these patients is based on retrospective analysis of angiographic reports or refer to time periods with incomparable treatment regimes, making them unusable for risk assessment in times of widespread use of reperfusion therapy. Aim of this study was to assess the outcome of premature AMI in a prospectively recruited study population enrolled in the times of modern reperfusion therapy. METHODS:We included 102 consecutive AMI survivors (≤40years) in this prospective multicentre study. Outcome was assessed via retrieval query of the Austrian Death Registry and the centralized patient management system of Vienna. RESULTS:During a median follow up time of 10.3years (IQR:8.9-11.1), 23% of all patients experienced MACE, of those 6% died, 17% experienced re-AMI and 5% patients an ischemic stroke. Furthermore, forty patients underwent cardiac re-catheterization and twenty-five needed recurrent revascularization. MACE were associated among the classic cardiovascular risk factors with elevated levels of HbA1c (adj. HR 1.32; 95%CI 1.06-1.64; P=0.012), total cholesterol (adj. HR 2.16; 95%CI 1.27-3.48; P=0.004), and c-reactive protein (adj. HR 1.67; 95%CI 1.29-2.17; P=0-003) for an increase of 1-standard deviation. CONCLUSION:Although myocardial re-infarction was the driving force of morbidity in premature myocardial infarction, we observed an excellent long-term survival opposed to previous reports. We found that persistence risk factors rather than the clinical risk profile at baseline influences the outcome in these patients, emphasizing the importance of secondary prevention in young patients after AMI.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

authors

Winter MP,Blessberger H,Alimohammadi A,Pavo N,Huber K,Wojta J,Lang IM,Wiesbauer F,Goliasch G

doi

10.1016/j.ijcard.2017.03.146

subject

Has Abstract

pub_date

2017-08-01 00:00:00

pages

37-42

eissn

0167-5273

issn

1874-1754

pii

S0167-5273(17)31143-9

journal_volume

240

pub_type

杂志文章,多中心研究

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Long-term outcome and risk assessment in premature acute myocardial infarction: A 10-year follow-up study.