Prognostic impact of demographic factors and clinical features on the mode of death in high-risk patients after myocardial infarction - A combined analysis from multicenter trials

Abstract

SummaryBackground: Contemporary information is lacking on the effect of demographic features and clinical features on the specific mode of mortality after myocardial infarction (MI) in the thrombolytic era.Hypothesis: The aims of this study were (1) to examine the risk and trend of a different mode of mortality (i.e., all-cause, arrhythmic, and nonarrhythmic cardiac mortality) in highrisk patients post MI with reduced left ventricular ejection fraction (LVEF) or ventricular arrhythmias; and (2) to assess the predictive value of demographic and clinical variables in the prediction of specific modes of death in high-risk patients post MI in the thrombolytic era.Methods: In all, 3,431 patients receiving placebo (2,700 men, median age 64 ± 11 years) from the EMIAT, CAMIAT, SWORD, TRACE, and DIAMOND-MI studies, with LVEF < 40% or ventricular arrhythmia were pooled. Risk factors for mortality among patients surviving ≥ 45 days after MI up to 2 years were examined using Cox regression. Short-term survival (from onset of MI to Day 44 after MI) was also examined for TRACE and DIAMOND-MI, in which patients were recruited within 2 weeks of MI.

High mortality in diabetic patients with acute myocardial infarction: Cardiovascular co-morbidities contribute most to the high risk

“…Although in the first place some degree of causal relationship exists between diabetes and the observed cardiovascular co-morbidities, diabetes per se appeared to account only moderately for the high overall mortality among the diabetic patients dealt with in an unselected AMI population. A recent analysis of pooled data from several AMI trials reported findings in line with our observations; the predictive value of death was higher for previous MI and history of angina than for diabetes [25].…”

Potential demographic and baselines variables for risk stratification of high-risk post-myocardial infarction patients in the era of implantable cardioverter-defibrillator — A prognostic indicator

“…We have demonstrated the prognostic values of these variables in our previous study [13]. Scores Fig.…”

Sudden Cardiac Death From the Perspective of Coronary Artery Disease

“…In addition, white men have the highest death rates, followed by men of other races, women of non-white races, and lastly, white women. Table 2 displays the composite hazard ratio for arrhythmic mortality for several risk factors as determined in a meta-analysis 39 of several trials (European Myocardial Infarct Amiodarone Trial, Canadian Amiodarone Myocardial Infarction Trial, Survival With Oral D-Sotalol trial, Trandolapril Cardiac Evaluation, and Dofetilide in Patients With Acute Myocardial Infarction and Left Ventricular Dysfunction Trial). These data indicate that traditional risk factors are important predictors of arrhythmic (and sudden cardiac) death in the post-MI setting among patients with ejection fractions (EFs) of less than 35% or premature ventricular complexes.…”