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Acute MI raises risk for long-term mortality in young patients
Younger patients with acute MI had a much higher risk for long-term mortality than a background population without MI matched for age, sex and follow-up year, according to results published in The American Journal of Cardiology.
However, younger patients with MI had a better prognosis compared with older patients with MI, the researchers wrote.
Mingxue Jing, MBBS, from National University Heart Centre, National University of Singapore, and colleagues analyzed data from a cohort of 15,151 patients with acute MI from 2000 to 2005. Of that group, 601 patients (6.8% women; 53.7% Chinese) were aged 40 years or younger and 14,550 patients (28.6% women; 67.2% Chinese) were older than 40 years.
During a median 7.31 years of follow-up, 7,454 patients died. All-cause mortality, unadjusted at 12 years, was higher in the older group (50.7%) than in the younger group (12.8%; P < .001). CV mortality occurred in 34.5% of the older group vs. 9.2% of the younger group (P < .001).
Jing and colleagues calculated the relative survival ratio (RSR), which was determined by the ratio of the survival of patients with acute MI divided by the estimated survival rate of the age-matched background population (n = 3,771,700). RSRs of less than 1 were poorer than the background population, and RSRs greater than 1 were better.
At 1 year, the RSR was 0.969 (95% CI, 0.95-0.98) in the younger group and 0.804 (95% CI, 0.797-0.811) in older group. Five-year RSRs were 0.942 (95% CI, 0.918-0.96) in the younger group and 0.716 (95% CI, 0.707-0.726) in the older group, whereas at 9 years, RSRs were 0.908 (95% CI, 0.878-0.938) in the younger group and 0.638 (95% CI, 0.62-0.654) in the older group.
The younger group has a “fivefold lower long-term mortality than older patients with [acute] MI” but smoking should be avoided because it is such a strong risk factor, the researchers wrote.
A previous study “showed that persistence of smoking is the most powerful predictor for the recurrence of cardiac events in patients with premature [acute] MI. This has important clinical implications,” the researchers wrote. “Because smoking is the most prevalent risk factor in the [younger] group, primary prevention programs should be highly promoted.” – by James Clark
Disclosure: The researchers report no relevant financial disclosures.