Two-year outcomes among stable high-risk patients following acute MI. Insights from a global registry in 25 countries
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Two-year outcomes among stable high-risk patients following acute MI. Insights from a global registry in 25 countries. / Brieger, David; Pocock, Stuart J; Blankenberg, Stefan; Chen, Ji Yan; Cohen, Mauricio G; Granger, Christopher B; Grieve, Richard; Nicolau, Jose C; Simon, Tabassome; Westermann, Dirk; Yasuda, Satoshi; Gregson, John; Rennie, Kirsten L; Hedman, Katarina; Sundell, Karolina Andersson; Goodman, Shaun G.
In: INT J CARDIOL, Vol. 311, 15.07.2020, p. 7-14.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Two-year outcomes among stable high-risk patients following acute MI. Insights from a global registry in 25 countries
AU - Brieger, David
AU - Pocock, Stuart J
AU - Blankenberg, Stefan
AU - Chen, Ji Yan
AU - Cohen, Mauricio G
AU - Granger, Christopher B
AU - Grieve, Richard
AU - Nicolau, Jose C
AU - Simon, Tabassome
AU - Westermann, Dirk
AU - Yasuda, Satoshi
AU - Gregson, John
AU - Rennie, Kirsten L
AU - Hedman, Katarina
AU - Sundell, Karolina Andersson
AU - Goodman, Shaun G
N1 - Copyright © 2020. Published by Elsevier B.V.
PY - 2020/7/15
Y1 - 2020/7/15
N2 - BACKGROUND: Evidence is lacking on long-term outcomes in unselected patients surviving the first year following myocardial infarction (MI).METHODS AND RESULTS: The TIGRIS (long-Term rIsk, clinical manaGement and healthcare Resource utilization of stable coronary artery dISease in post-myocardial infarction patients) prospective registry enrolled 9176 eligible patients aged ≥50 years, 1-3 years post-MI, from 25 countries. All had ≥1 risk factor: age ≥ 65 years, diabetes mellitus, second prior MI, multivessel coronary artery disease, chronic kidney disease (CKD). Primary outcome was a composite of MI, unstable angina with urgent revascularization, stroke, or all-cause death at 2-year follow-up. Bleeding requiring hospitalization was also recorded. 9027 patients (98.4%) provided follow-up data: the primary outcome occurred in 621 (7.0%), all-cause mortality in 295 (3.3%), and bleeding in 109 (1.2%) patients. Events accrued linearly over time. In multivariable analyses, qualifying risk factors were associated with increased risk of primary outcome (incidence rate ratio [RR] per 100 patient-years [95% confidence interval]): CKD 2.06 (1.66, 2.55), second prior MI 1.71 (1.38, 2.10), diabetes mellitus 1.63 (1.39, 1.92), age ≥ 65 years 1.53 (1.28, 1.83), and multivessel disease 1.24 (1.05, 1.48). Risk of bleeding events was greater in older patients (vs <65 years) 65-74 years 2.68 (1.53, 4.70), ≥75 years 4.62 (2.57, 8.28), and those with CKD 1.99 (1.18, 3.35).CONCLUSION: In stable patients recruited 1-3 years post-MI, recurrent cardiovascular and bleeding events accrued linearly over 2 years. Factors independently predictive of ischemic and bleeding events were identified, providing a context for deciding on treatment options.
AB - BACKGROUND: Evidence is lacking on long-term outcomes in unselected patients surviving the first year following myocardial infarction (MI).METHODS AND RESULTS: The TIGRIS (long-Term rIsk, clinical manaGement and healthcare Resource utilization of stable coronary artery dISease in post-myocardial infarction patients) prospective registry enrolled 9176 eligible patients aged ≥50 years, 1-3 years post-MI, from 25 countries. All had ≥1 risk factor: age ≥ 65 years, diabetes mellitus, second prior MI, multivessel coronary artery disease, chronic kidney disease (CKD). Primary outcome was a composite of MI, unstable angina with urgent revascularization, stroke, or all-cause death at 2-year follow-up. Bleeding requiring hospitalization was also recorded. 9027 patients (98.4%) provided follow-up data: the primary outcome occurred in 621 (7.0%), all-cause mortality in 295 (3.3%), and bleeding in 109 (1.2%) patients. Events accrued linearly over time. In multivariable analyses, qualifying risk factors were associated with increased risk of primary outcome (incidence rate ratio [RR] per 100 patient-years [95% confidence interval]): CKD 2.06 (1.66, 2.55), second prior MI 1.71 (1.38, 2.10), diabetes mellitus 1.63 (1.39, 1.92), age ≥ 65 years 1.53 (1.28, 1.83), and multivessel disease 1.24 (1.05, 1.48). Risk of bleeding events was greater in older patients (vs <65 years) 65-74 years 2.68 (1.53, 4.70), ≥75 years 4.62 (2.57, 8.28), and those with CKD 1.99 (1.18, 3.35).CONCLUSION: In stable patients recruited 1-3 years post-MI, recurrent cardiovascular and bleeding events accrued linearly over 2 years. Factors independently predictive of ischemic and bleeding events were identified, providing a context for deciding on treatment options.
KW - Aged
KW - Coronary Artery Disease
KW - Humans
KW - Myocardial Infarction/diagnosis
KW - Registries
KW - Risk Factors
KW - Stroke
KW - Treatment Outcome
U2 - 10.1016/j.ijcard.2020.01.070
DO - 10.1016/j.ijcard.2020.01.070
M3 - SCORING: Journal article
C2 - 32057476
VL - 311
SP - 7
EP - 14
JO - INT J CARDIOL
JF - INT J CARDIOL
SN - 0167-5273
ER -