Long-Term Predictors of Hospitalized Reinfarction after an Incident Acute Myocardial Infarction

Abstract

The aim of this study was to compare characteristics of incident acute myocardial infarction (AMI) and first and second time reinfarctions in terms of sociodemographic characteristics, comorbidities, symptoms, treatment, clinical characteristics, medication and outcome. A further aim was to identify predictors for an increased risk of hospitalized reinfarction. Between 2000 and 2017, a total of 13,276 AMI cases were recorded by a population-based registry in the area of Augsburg, Germany, and were included in this study (11,871 incident events, 1217 cases of first-time reinfarction and 202 cases of second-time reinfarction). Median follow-up time was 5.3 years. For differences in baseline characteristics, Chi-square tests and analysis of variance (ANOVA) were calculated. To determine factors that are associated with an increased risk of hospitalized reinfarction COX regression models were fitted. Myocardial reinfarctions differ from incident events in some major characteristics such as the frequency of comorbidities, laboratory values, ECG presentation and therapy, but not regarding 28-day mortality. Moreover, typical comorbidities and risk factors (diabetes, hypertension, hyperlipidemia, smoking, impaired renal function) are associated with an increased risk of hospitalized reinfarction. Conversely, STEMI ECG, being married, German nationality and bypass surgery are predictors for a lower risk of hospitalized reinfarction. Incident AMI and reinfarction are distinctly different in many characteristics, which physicians should have in mind when treating patients with prior AMI. Typical comorbidities are risk factors for hospitalized reinfarction. This underlines the importance of comprehensive treatment of these comorbidities including education of patients and encouragement towards lifestyle adjustments.

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“…ST1A1, like STAMBP, is down-regulated during late pregnancy in women with postpartum depression (Bränn et al, 2017) and is associated with an increased risk of esophageal squamous cell carcinoma (Aversa et al, 2020). Furthermore, changes in ST1A1 expression may also cause inflammation in the skin lesions of patients with cutaneous leishmaniasis (Taslimi et al, 2020) and predict short-term mortality in patients with acute myocardial infarction (Schmitz et al, 2022). SIRT2 is the only NAD-dependent deacetylase primarily localized in the cytoplasm, which plays an important regulatory role in biological processes such as neural cell differentiation and survival, mitotic regulation, genomic integrity, cell differentiation, cell homeostasis, aging, infection, inflammation, oxidative stress, and autophagy (Wang et al, 2019).…”