Predictors of six-month major adverse cardiac events in 30-day survivors after acute myocardial infarction (from the Korea Acute Myocardial Infarction Registry).
Little is known about risk factors for 6-month major adverse cardiac events (MACEs) in 30-day survivors after acute myocardial infarction (AMI). We investigated predictors of 6-month MACE in 30-day survivors after MI from the Korea Acute Myocardial Infarction Registry (KAMIR). From November 2005 to January 2008, 9,706 patients (6,983 men, mean age 64.0 +/- 12.4 years) who survived >30 days after AMI were analyzed. The primary end point was 6-month MACEs including death, MI, and revascularization. During 6-month follow-up, 317 patients (3.2%) had MACEs including 66 (0.6%) deaths, 23 (0.2%) recurrent MIs, and 218 (2.2%) revascularizations. In multivariate logistic regression analysis, factors reflecting demographics (body mass index), severity of left ventricular systolic dysfunction (Killip class >I, in-hospital cardiogenic shock, use of intra-aortic balloon pump), residual myocardial ischemia (previous coronary heart disease, multivessel disease), and electrical instability (ventricular tachycardia/ventricular fibrillation on admission) were independent predictors of 6-month MACEs after adjustment for clinical, angiographic, and procedural data. Plasma level of N-terminal pro-B-type natriuretic peptide provided an additional prognostic value predicting 6-month MACEs. In conclusion, this study provides useful prognostic information for clinicians to advise patients who have survived the acute phase of MI. More intensive management is needed in survivors after MI with these high-risk features.
Lee
Jang Hoon
JH
Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.
Park
Hun Sik
HS
Chae
Shung Chull
SC
Cho
Yongkeun
Y
Yang
Dong Heon
DH
Jeong
Myung Ho
MH
Kim
Young Jo
YJ
Kim
Kee-Sik
KS
Hur
Seung Ho
SH
Seong
In Whan
IW
Hong
Taek Jong
TJ
Cho
Myeong Chan
MC
Kim
Chong Jin
CJ
Jun
Jae Eun
JE
Park
Wee Hyun
WH
D000368:Aged; D016001:Confidence Intervals; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D007723:Korea / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000150:complications* / Q000453:epidemiology / Q000401:mortality* / Q000503:physiopathology; D020097:Natriuretic Peptide, Brain / Q000097:blood; D016017:Odds Ratio; D010446:Peptide Fragments / Q000097:blood; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain