Long-Term Clinical Outcomes According to Previous Manifestations of Atherosclerotic Disease (from the FAST-MI 2010 Registry).
Fiche publication
Date publication
mars 2017
Journal
The American journal of cardiology
Auteurs
Membres identifiés du Cancéropôle Est :
Pr COTTIN Yves
Tous les auteurs :
Puymirat E, Aissaoui N, Lemesle G, Cottin Y, Coste P, Schiele F, Ferrières J, Simon T, Danchin N,
Lien Pubmed
Résumé
The prognosis of patients with acute myocardial infarction (AMI) has notably improved in the past 20 years. Using the French Registry of ST-Elevation and Non-ST-elevation Myocardial Infarction (FAST-MI) 2010 registry, we investigated whether previous manifestations of atherosclerotic disease (i.e., previous MI, or a history of any form of atherosclerotic disease) are at truly increased risk compared with those in whom AMI is the first manifestation of the disease. FAST-MI 2010 is a nationwide French registry including 3,079 patients with AMI, among whom 1,062 patients had a history of cardiovascular atherosclerotic disease and 498 patients had a history of MI. Overall, patients with a history of atherosclerotic disease (or MI) were older compared with patients without known cardiovascular disease (71 ± 13 vs 63 ± 14 years) and had higher cardiovascular risk profiles and co-morbidities. Using fully adjusted Cox multivariate analysis, previous manifestations of atherosclerotic disease were associated with higher 3-year mortality (hazard ratio 1.80, 95% confidence interval 1.40 to 2.31; p <0.001) as history of previous MI alone (hazard ratio 1.32, 95% confidence interval 1.00 to 1.73; p = 0.048). Similar results were found in patients discharged alive. In conclusion, previous cardiovascular atherosclerotic disease represents 1/3 of patients with AMI and are strongly associated with worse long-term clinical outcomes. Intensive follow-up and therapy should be encouraged in this high-risk population.
Mots clés
Adrenergic beta-Antagonists, therapeutic use, Age Distribution, Aged, Aged, 80 and over, Angiotensin Receptor Antagonists, therapeutic use, Angiotensin-Converting Enzyme Inhibitors, therapeutic use, Atherosclerosis, epidemiology, Case-Control Studies, Cause of Death, Cerebrovascular Disorders, epidemiology, Coronary Artery Bypass, Coronary Artery Disease, epidemiology, Female, France, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors, therapeutic use, Longitudinal Studies, Male, Middle Aged, Mortality, Multivariate Analysis, Myocardial Infarction, epidemiology, Percutaneous Coronary Intervention, Platelet Aggregation Inhibitors, therapeutic use, Prognosis, Proportional Hazards Models, Prospective Studies, Registries, Risk Factors, Treatment Outcome
Référence
Am. J. Cardiol.. 2017 Mar;119(5):692-697