Temporal Trends in Cardiovascular Events After Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction

Pernille Gro Thrane; Kevin Kris Warnakula Olesen; Troels Thim; Christine Gyldenkerne; Malene Kærslund Hansen; Nina Stødkilde-Jørgensen; Steen Dalby Kristensen; Michael Maeng

doi:10.1016/j.jacadv.2025.101614

Temporal Trends in Cardiovascular Events After Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction

Pernille Gro Thrane^*, Kevin Kris Warnakula Olesen, Troels Thim, Christine Gyldenkerne, Malene Kærslund Hansen, Nina Stødkilde-Jørgensen, Steen Dalby Kristensen, Michael Maeng

^*Corresponding author af dette arbejde

Institut for Klinisk Medicin - Hjertesygdomme

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

Abstract

Background: Primary percutaneous coronary intervention (pPCI) has been the national reperfusion strategy for patients with ST-segment elevation myocardial infarction (STEMI) in Denmark since 2003. We recently reported a gradual reduction in 1-year mortality in patients with pPCI-treated STEMI. To elucidate potential causes of this reduction, we examined trends in major adverse cardiovascular events (MACE). Objectives: The purpose of this study was to examine trends in 1-year risk of MACE following pPCI-treated STEMI from 2003 to 2017. Methods: The Western Denmark Heart Registry was used to identify first-time PCI-treated patients undergoing pPCI for STEMI from 2003 to 2017. Patients were categorized into 4 time periods (2003-2006, 2007-2010, 2011-2014, and 2015-2017) and the main outcome was 1-year MACE, defined as recurrent myocardial infarction, ischemic stroke, or cardiovascular death. Temporal changes were compared to those of an age- and sex-matched general population. Results: We included 18,540 first-time pPCI-treated STEMI patients between 2003 and 2017. The 1-year risk of MACE decreased from 13.0% in 2003-2006 to 8.7% in 2015-2017 (adjusted HR: 0.67; 95% CI: 0.58-0.76). Similar relative reductions were observed for the individual components of MACE. Cardiovascular death was the most common outcome and the largest contributor to the absolute reduction in MACE. Compared to the matched general population, STEMI patients had 11% higher 1-year risk of MACE in 2003 to 2006, a risk difference that decreased to 7% in 2015 to 2017. Conclusions: In Western Denmark, with a fully implemented pPCI strategy, the 1-year risk of MACE and its individual components declined gradually by one-third in pPCI-treated STEMI patients from 2003 to 2017.

Originalsprog	Engelsk
Artikelnummer	101614
Tidsskrift	JACC: Advances
Vol/bind	4
Nummer	3
ISSN	2772-963X
DOI	https://doi.org/10.1016/j.jacadv.2025.101614
Status	Udgivet - mar. 2025

Adgang til dokumentet

10.1016/j.jacadv.2025.101614Licens: CC BY-NC-ND

Andre filer og links

Link to publication in Scopus

Citationsformater

@article{5669f80ffdcd416fbeb9f8ae72c93ace,

title = "Temporal Trends in Cardiovascular Events After Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction",

abstract = "Background: Primary percutaneous coronary intervention (pPCI) has been the national reperfusion strategy for patients with ST-segment elevation myocardial infarction (STEMI) in Denmark since 2003. We recently reported a gradual reduction in 1-year mortality in patients with pPCI-treated STEMI. To elucidate potential causes of this reduction, we examined trends in major adverse cardiovascular events (MACE). Objectives: The purpose of this study was to examine trends in 1-year risk of MACE following pPCI-treated STEMI from 2003 to 2017. Methods: The Western Denmark Heart Registry was used to identify first-time PCI-treated patients undergoing pPCI for STEMI from 2003 to 2017. Patients were categorized into 4 time periods (2003-2006, 2007-2010, 2011-2014, and 2015-2017) and the main outcome was 1-year MACE, defined as recurrent myocardial infarction, ischemic stroke, or cardiovascular death. Temporal changes were compared to those of an age- and sex-matched general population. Results: We included 18,540 first-time pPCI-treated STEMI patients between 2003 and 2017. The 1-year risk of MACE decreased from 13.0% in 2003-2006 to 8.7% in 2015-2017 (adjusted HR: 0.67; 95% CI: 0.58-0.76). Similar relative reductions were observed for the individual components of MACE. Cardiovascular death was the most common outcome and the largest contributor to the absolute reduction in MACE. Compared to the matched general population, STEMI patients had 11% higher 1-year risk of MACE in 2003 to 2006, a risk difference that decreased to 7% in 2015 to 2017. Conclusions: In Western Denmark, with a fully implemented pPCI strategy, the 1-year risk of MACE and its individual components declined gradually by one-third in pPCI-treated STEMI patients from 2003 to 2017.",

keywords = "myocardial infarction, outcomes, prognosis, revascularization, time-trends",

author = "Thrane, {Pernille Gro} and Olesen, {Kevin Kris Warnakula} and Troels Thim and Christine Gyldenkerne and Hansen, {Malene K{\ae}rslund} and Nina St{\o}dkilde-J{\o}rgensen and Kristensen, {Steen Dalby} and Michael Maeng",

note = "Publisher Copyright: {\textcopyright} 2025 The Authors",

year = "2025",

month = mar,

doi = "10.1016/j.jacadv.2025.101614",

language = "English",

volume = "4",

journal = "JACC: Advances",

issn = "2772-963X",

publisher = "Elsevier B.V.",

number = "3",

}

Temporal Trends in Cardiovascular Events After Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction. / Thrane, Pernille Gro ; Olesen, Kevin Kris Warnakula ; Thim, Troels et al.
I: JACC: Advances, Bind 4, Nr. 3, 101614, 03.2025.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

TY - JOUR

T1 - Temporal Trends in Cardiovascular Events After Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction

AU - Thrane, Pernille Gro

AU - Olesen, Kevin Kris Warnakula

AU - Thim, Troels

AU - Gyldenkerne, Christine

AU - Hansen, Malene Kærslund

AU - Stødkilde-Jørgensen, Nina

AU - Kristensen, Steen Dalby

AU - Maeng, Michael

PY - 2025/3

Y1 - 2025/3

N2 - Background: Primary percutaneous coronary intervention (pPCI) has been the national reperfusion strategy for patients with ST-segment elevation myocardial infarction (STEMI) in Denmark since 2003. We recently reported a gradual reduction in 1-year mortality in patients with pPCI-treated STEMI. To elucidate potential causes of this reduction, we examined trends in major adverse cardiovascular events (MACE). Objectives: The purpose of this study was to examine trends in 1-year risk of MACE following pPCI-treated STEMI from 2003 to 2017. Methods: The Western Denmark Heart Registry was used to identify first-time PCI-treated patients undergoing pPCI for STEMI from 2003 to 2017. Patients were categorized into 4 time periods (2003-2006, 2007-2010, 2011-2014, and 2015-2017) and the main outcome was 1-year MACE, defined as recurrent myocardial infarction, ischemic stroke, or cardiovascular death. Temporal changes were compared to those of an age- and sex-matched general population. Results: We included 18,540 first-time pPCI-treated STEMI patients between 2003 and 2017. The 1-year risk of MACE decreased from 13.0% in 2003-2006 to 8.7% in 2015-2017 (adjusted HR: 0.67; 95% CI: 0.58-0.76). Similar relative reductions were observed for the individual components of MACE. Cardiovascular death was the most common outcome and the largest contributor to the absolute reduction in MACE. Compared to the matched general population, STEMI patients had 11% higher 1-year risk of MACE in 2003 to 2006, a risk difference that decreased to 7% in 2015 to 2017. Conclusions: In Western Denmark, with a fully implemented pPCI strategy, the 1-year risk of MACE and its individual components declined gradually by one-third in pPCI-treated STEMI patients from 2003 to 2017.

AB - Background: Primary percutaneous coronary intervention (pPCI) has been the national reperfusion strategy for patients with ST-segment elevation myocardial infarction (STEMI) in Denmark since 2003. We recently reported a gradual reduction in 1-year mortality in patients with pPCI-treated STEMI. To elucidate potential causes of this reduction, we examined trends in major adverse cardiovascular events (MACE). Objectives: The purpose of this study was to examine trends in 1-year risk of MACE following pPCI-treated STEMI from 2003 to 2017. Methods: The Western Denmark Heart Registry was used to identify first-time PCI-treated patients undergoing pPCI for STEMI from 2003 to 2017. Patients were categorized into 4 time periods (2003-2006, 2007-2010, 2011-2014, and 2015-2017) and the main outcome was 1-year MACE, defined as recurrent myocardial infarction, ischemic stroke, or cardiovascular death. Temporal changes were compared to those of an age- and sex-matched general population. Results: We included 18,540 first-time pPCI-treated STEMI patients between 2003 and 2017. The 1-year risk of MACE decreased from 13.0% in 2003-2006 to 8.7% in 2015-2017 (adjusted HR: 0.67; 95% CI: 0.58-0.76). Similar relative reductions were observed for the individual components of MACE. Cardiovascular death was the most common outcome and the largest contributor to the absolute reduction in MACE. Compared to the matched general population, STEMI patients had 11% higher 1-year risk of MACE in 2003 to 2006, a risk difference that decreased to 7% in 2015 to 2017. Conclusions: In Western Denmark, with a fully implemented pPCI strategy, the 1-year risk of MACE and its individual components declined gradually by one-third in pPCI-treated STEMI patients from 2003 to 2017.

KW - myocardial infarction

KW - outcomes

KW - prognosis

KW - revascularization

KW - time-trends

UR - http://www.scopus.com/inward/record.url?scp=85217940738&partnerID=8YFLogxK

U2 - 10.1016/j.jacadv.2025.101614

DO - 10.1016/j.jacadv.2025.101614

M3 - Journal article

C2 - 39983611

AN - SCOPUS:85217940738

SN - 2772-963X

VL - 4

JO - JACC: Advances

JF - JACC: Advances

IS - 3

M1 - 101614

ER -

Temporal Trends in Cardiovascular Events After Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction

Abstract

Adgang til dokumentet

Andre filer og links

Fingeraftryk

Citationsformater