Development and Validation of Prognostic Models for Myocardial Infarction, Stroke and Cardiovascular Death and Hospitalised Bleeding in Stable Myocardial Infarction Survivors

Pasea, Laura; Chung, Sheng‐Chia; Rodriguez, Mar Pujades; Jennings, Em; Emmas, Cathy; Westergaard, Mogens; Johansson, Saga; Hemingway, Harry

doi:10.1016/s0735-1097(15)61382-1

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“…Current guidelines recommend DAPT for 12 months for secondary prevention [ 26 – 29 ], with European Society of Cardiology guidelines noting that the duration may be extended (up to 30 months) in selected patients, if required [ 27 ]. In patients stable 1 year after an AMI, validated prognostic models based on individual patient risk profiles can help to inform a decision of whether or not to prolong DAPT [ 30 ].…”

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confidence: 99%

Mortality and morbidity trends after the first year in survivors of acute myocardial infarction: a systematic review

Johansson

Rosengren

Young

et al. 2017

BMC Cardiovasc Disord

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BackgroundMost studies of outcomes after myocardial infarction (MI) focus on the acute phase after the index event. We assessed mortality and morbidity trends after the first year in survivors of acute MI, by conducting a systematic literature review.MethodsLiterature searches were conducted in Embase, MEDLINE, and the Cochrane Database of Systematic Reviews to identify epidemiological studies of long-term (>10 years) mortality and morbidity trends in individuals who had experienced an acute MI more than 1 year previously.ResultsThirteen articles met the inclusion criteria. Secular trends showed a consistent decrease in mortality and morbidity after acute MI from early to more recent study periods. The relative risk for all-cause death and cardiovascular outcomes (recurrent MI, cardiovascular death) was at least 30% higher than that in a general reference population at both 1–3 years and 3–5 years after MI. Risk factors leading to worse outcomes after MI included comorbid diabetes, hypertension and peripheral artery disease, older age, reduced renal function, and history of stroke.ConclusionsThere have been consistent improvements in secular trends for long-term survival and cardiovascular outcomes after MI. However, MI survivors remain at higher risk than the general population, particularly when additional risk factors such as diabetes, hypertension, or older age are present.

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