Excess long-term mortality among hospital survivors of acute myocardial infarction. Soroka Acute Myocardial Infarction (SAMI) project.
OBJECTIVE
We evaluated long-term survival after acute myocardial infarction (AMI) in unselected 'real life' patients according to the various risk groups, and it's persistence with time after AMI as compared with the matched general population.


METHODS
Retrospective study.


METHODS
Data were collected from 2671 AMI hospital survivors (tertiary medical centre in Israel), which included demographics, clinical characteristics of AMI, comorbidities, interventions and test results. All-cause mortality during the 10-year follow-up period was compared with age-, sex- and ethnicity/religion-matched general population using standardized mortality ratios (SMRs).


RESULTS
Overall mortality of AMI patients (48.6%) was higher than the general population (SMR, 2.2; P < 0.001). Mortality rates and SMRs tended to be greater in higher risk strata of patients, Jews vs Muslims, women vs men, non-ST-elevation acute myocardial infarction (NSTEMI) vs ST-elevation acute myocardial infarction (STEMI), non-invasive treatment vs invasive treatment, and recurrent vs first AMI. Mortality rates increased with age, but SMRs were highest in the youngest group. Through the follow-up period, SMR was highest during the first year after discharge (SMR, 4.85; P < 0.001) and higher in 7th-10th years compared with 2nd-6th years.


CONCLUSIONS
Patients who survived hospital admission with AMI continue to be at higher (approximately twice) risk of death compared with the general population for at least 10-year follow-up period and especially throughout the first and 7th-10th years after AMI, young women, high-risk patients, Jews, NSTEMI, non-invasively treated and recurrent AMI. These findings can assist healthcare providers and decision makers prioritizing targets of secondary prevention and allocation of resources.
Nursing Research Unit, Soroka University Medical Center, Beer-Sheva, Israel; Recanati School for Community Health Professions, Department of Nursing, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. Electronic address: Plakht@bgu.ac.il.
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Plakht
Department of Cardiology, Soroka University Medical Center, Beer-Sheva, Israel; Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
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Gilutz
Department of Internal Medicine E, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.
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Shiyovich
D000368:Aged; D005260:Female; D006760:Hospitalization; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D009203:Myocardial Infarction / Q000628:therapy*; D012189:Retrospective Studies; D017741:Survivors / Q000706:statistics & numerical data*; D013997:Time Factors
Acute myocardial infarction; All-cause mortality; General population; Prognosis