10-Year Mortality After ST-Segment Elevation Myocardial Infarction Compared to the General Population

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

doi:10.1016/j.jacc.2024.04.025

10-Year Mortality After ST-Segment Elevation Myocardial Infarction Compared to the General Population

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

^*Corresponding author for this work

Department of Clinical Medicine - The Department of Cardiological Medicine B

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

Background: ST-segment elevation myocardial infarction (STEMI) is associated with high early mortality. However, it remains unclear if patients surviving the early phase have long-term excess mortality. Objectives: This study aims to assess excess mortality in STEMI patients treated with primary percutaneous coronary intervention (PCI) compared with an age- and- sex-matched general population at landmark periods 0 to 30 days, 31 to 90 days, and 91 days to 10 years. Methods: Using the Western Denmark Heart Registry, we identified first-time PCI-treated patients who had primary PCI for STEMI from January 2003 to October 2018. Each patient was matched by age and sex to 5 individuals from the general population. Results: We included 18,818 patients with first-time STEMI and 94,090 individuals from the general population. Baseline comorbidity burden was similar in STEMI patients and matched individuals. Compared with the matched individuals, STEMI was associated with a 5.9% excess mortality from 0 to 30 days (6.0% vs 0.2%; HR: 36.44; 95% CI: 30.86-43.04). An excess mortality remained present from 31 to 90 days (0.9% vs 0.4%; HR: 2.43; 95% CI: 2.02-2.93). However, in 90-day STEMI survivors, the absolute excess mortality was only 2.1 percentage points at 10-year follow-up (26.5% vs 24.5%; HR: 1.04; 95% CI: 1.01-1.08). Use of secondary preventive medications such as statins, antiplatelet therapy, and beta-blockers was very high in STEMI patients throughout 10-year follow-up. Conclusions: In primary PCI-treated STEMI patients with high use of guideline-recommended therapy, patients surviving the first 90 days had 10-year mortality that was only 2% higher than that of a matched general population.

Original language	English
Journal	Journal of the American College of Cardiology
Volume	83
Issue	25
Pages (from-to)	2615-2625
Number of pages	11
ISSN	0735-1097
DOIs	https://doi.org/10.1016/j.jacc.2024.04.025
Publication status	Published - Jun 2024

Keywords

excess risk
myocardial infarction
percutaneous coronary intervention
prognosis
survival

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10.1016/j.jacc.2024.04.025

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Thrane, P. G., Olesen, K. K. W., Thim, T., Gyldenkerne, C., Hansen, M. K., Stødkilde-Jørgensen, N., Jakobsen, L., Bødtker Mortensen, M., Dalby Kristensen, S., & Maeng, M. (2024). 10-Year Mortality After ST-Segment Elevation Myocardial Infarction Compared to the General Population. Journal of the American College of Cardiology, 83(25), 2615-2625. https://doi.org/10.1016/j.jacc.2024.04.025

@article{c712140f3e984210a68f698b5dd0d42a,

title = "10-Year Mortality After ST-Segment Elevation Myocardial Infarction Compared to the General Population",

abstract = "Background: ST-segment elevation myocardial infarction (STEMI) is associated with high early mortality. However, it remains unclear if patients surviving the early phase have long-term excess mortality. Objectives: This study aims to assess excess mortality in STEMI patients treated with primary percutaneous coronary intervention (PCI) compared with an age- and- sex-matched general population at landmark periods 0 to 30 days, 31 to 90 days, and 91 days to 10 years. Methods: Using the Western Denmark Heart Registry, we identified first-time PCI-treated patients who had primary PCI for STEMI from January 2003 to October 2018. Each patient was matched by age and sex to 5 individuals from the general population. Results: We included 18,818 patients with first-time STEMI and 94,090 individuals from the general population. Baseline comorbidity burden was similar in STEMI patients and matched individuals. Compared with the matched individuals, STEMI was associated with a 5.9% excess mortality from 0 to 30 days (6.0% vs 0.2%; HR: 36.44; 95% CI: 30.86-43.04). An excess mortality remained present from 31 to 90 days (0.9% vs 0.4%; HR: 2.43; 95% CI: 2.02-2.93). However, in 90-day STEMI survivors, the absolute excess mortality was only 2.1 percentage points at 10-year follow-up (26.5% vs 24.5%; HR: 1.04; 95% CI: 1.01-1.08). Use of secondary preventive medications such as statins, antiplatelet therapy, and beta-blockers was very high in STEMI patients throughout 10-year follow-up. Conclusions: In primary PCI-treated STEMI patients with high use of guideline-recommended therapy, patients surviving the first 90 days had 10-year mortality that was only 2% higher than that of a matched general population.",

keywords = "excess risk, myocardial infarction, percutaneous coronary intervention, prognosis, survival",

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 Lars Jakobsen and {B{\o}dtker Mortensen}, Martin and {Dalby Kristensen}, Steen and Michael Maeng",

year = "2024",

month = jun,

doi = "10.1016/j.jacc.2024.04.025",

language = "English",

volume = "83",

pages = "2615--2625",

journal = "Journal of the American College of Cardiology",

issn = "0735-1097",

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}

Thrane, PG , Olesen, KKW , Thim, T , Gyldenkerne, C , Hansen, MK , Stødkilde-Jørgensen, N , Jakobsen, L , Bødtker Mortensen, M , Dalby Kristensen, S & Maeng, M 2024, '10-Year Mortality After ST-Segment Elevation Myocardial Infarction Compared to the General Population', Journal of the American College of Cardiology, vol. 83, no. 25, pp. 2615-2625. https://doi.org/10.1016/j.jacc.2024.04.025

10-Year Mortality After ST-Segment Elevation Myocardial Infarction Compared to the General Population. / Thrane, Pernille Gro ; Olesen, Kevin Kris Warnakula ; Thim, Troels et al.
In: Journal of the American College of Cardiology, Vol. 83, No. 25, 06.2024, p. 2615-2625.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - 10-Year Mortality After ST-Segment Elevation Myocardial Infarction Compared to the General Population

AU - Thrane, Pernille Gro

AU - Olesen, Kevin Kris Warnakula

AU - Thim, Troels

AU - Gyldenkerne, Christine

AU - Hansen, Malene Kærslund

AU - Stødkilde-Jørgensen, Nina

AU - Jakobsen, Lars

AU - Bødtker Mortensen, Martin

AU - Dalby Kristensen, Steen

AU - Maeng, Michael

PY - 2024/6

Y1 - 2024/6

N2 - Background: ST-segment elevation myocardial infarction (STEMI) is associated with high early mortality. However, it remains unclear if patients surviving the early phase have long-term excess mortality. Objectives: This study aims to assess excess mortality in STEMI patients treated with primary percutaneous coronary intervention (PCI) compared with an age- and- sex-matched general population at landmark periods 0 to 30 days, 31 to 90 days, and 91 days to 10 years. Methods: Using the Western Denmark Heart Registry, we identified first-time PCI-treated patients who had primary PCI for STEMI from January 2003 to October 2018. Each patient was matched by age and sex to 5 individuals from the general population. Results: We included 18,818 patients with first-time STEMI and 94,090 individuals from the general population. Baseline comorbidity burden was similar in STEMI patients and matched individuals. Compared with the matched individuals, STEMI was associated with a 5.9% excess mortality from 0 to 30 days (6.0% vs 0.2%; HR: 36.44; 95% CI: 30.86-43.04). An excess mortality remained present from 31 to 90 days (0.9% vs 0.4%; HR: 2.43; 95% CI: 2.02-2.93). However, in 90-day STEMI survivors, the absolute excess mortality was only 2.1 percentage points at 10-year follow-up (26.5% vs 24.5%; HR: 1.04; 95% CI: 1.01-1.08). Use of secondary preventive medications such as statins, antiplatelet therapy, and beta-blockers was very high in STEMI patients throughout 10-year follow-up. Conclusions: In primary PCI-treated STEMI patients with high use of guideline-recommended therapy, patients surviving the first 90 days had 10-year mortality that was only 2% higher than that of a matched general population.

AB - Background: ST-segment elevation myocardial infarction (STEMI) is associated with high early mortality. However, it remains unclear if patients surviving the early phase have long-term excess mortality. Objectives: This study aims to assess excess mortality in STEMI patients treated with primary percutaneous coronary intervention (PCI) compared with an age- and- sex-matched general population at landmark periods 0 to 30 days, 31 to 90 days, and 91 days to 10 years. Methods: Using the Western Denmark Heart Registry, we identified first-time PCI-treated patients who had primary PCI for STEMI from January 2003 to October 2018. Each patient was matched by age and sex to 5 individuals from the general population. Results: We included 18,818 patients with first-time STEMI and 94,090 individuals from the general population. Baseline comorbidity burden was similar in STEMI patients and matched individuals. Compared with the matched individuals, STEMI was associated with a 5.9% excess mortality from 0 to 30 days (6.0% vs 0.2%; HR: 36.44; 95% CI: 30.86-43.04). An excess mortality remained present from 31 to 90 days (0.9% vs 0.4%; HR: 2.43; 95% CI: 2.02-2.93). However, in 90-day STEMI survivors, the absolute excess mortality was only 2.1 percentage points at 10-year follow-up (26.5% vs 24.5%; HR: 1.04; 95% CI: 1.01-1.08). Use of secondary preventive medications such as statins, antiplatelet therapy, and beta-blockers was very high in STEMI patients throughout 10-year follow-up. Conclusions: In primary PCI-treated STEMI patients with high use of guideline-recommended therapy, patients surviving the first 90 days had 10-year mortality that was only 2% higher than that of a matched general population.

KW - excess risk

KW - myocardial infarction

KW - percutaneous coronary intervention

KW - prognosis

KW - survival

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U2 - 10.1016/j.jacc.2024.04.025

DO - 10.1016/j.jacc.2024.04.025

M3 - Journal article

AN - SCOPUS:85195395055

SN - 0735-1097

VL - 83

SP - 2615

EP - 2625

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

IS - 25

ER -

10-Year Mortality After ST-Segment Elevation Myocardial Infarction Compared to the General Population

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