This article is more than 5 years old. Information may no longer be current.
MI at age younger than 50 years confers elevated mortality risk
Click Here to Manage Email Alerts
While risk for premature death after MI in patients aged 50 years and younger has significantly declined, their long-term mortality risk is still almost twice as high as those in the general population.
According to a new study published in Circulation: Cardiovascular Quality and Outcomes, this is largely due to heart disease and other smoking disease and can be drastically reduced by quitting smoking and adopting healthy eating habits.
“It is estimated that half of the decline in deaths from [MIs] since 1980 is attributed to primary prevention and in particular, the reduction in the numbers of patients who smoke,” Morten Schmidt, MD, PhD, from the department of clinical epidemiology at Aarhus University Hospital, Skejby, Denmark, said in a press release. “The other half is likely attributable to a combination of things such as the introduction of early treatments that restore blood flow to the part of the heart muscle damaged during [MI], improvement in hospital organization and better management of high [BP] and high cholesterol.”
The study was based on a cohort of 21,693 of MI survivors aged 50 years and younger (mean age, 45 years; 80% men) who were compared with a general population cohort of 216,930 over a mean of 11 years.
The majority of patients studied in the MI survivor cohort (83.6%) were between the ages of 40 and 49 years, while 1.8% were under 30 years of age.
The researchers found that between 1980-1989 and 2000-2009, MI deaths declined from 12.5% to 3.2% within 30 days, from 5.1% to 1.6% within 31 to 365 days and from 24.2% to 8.9% within 1 to 10 years.
After adjustment for age, sex and comorbidities, the mortality rate ratio for those with MI at age younger than 50 vs. the general population dropped at 30 days from 468 in 1980-89 to 97 in 2000-09, dropped at 31 to 365 days from 11.32 in 1980-89 to 3.7 in 2000-09, and dropped at 1 to 10 years from 4.77 in 1980-89 to 1.89 in 2000-09, the researchers wrote.
Schmidt and colleagues wrote that the 1.89 mortality rate ratio for 1 to 10 years after MI in 2000-09 translates to six additional deaths per year per 1,000 patients compared with the general population. The most common causes of death among MI survivors were CVD and chronic pulmonary disease, they wrote.
Women with MI before age 50 were 3 times more likely to die and men in the same category were 1.7 times more likely to die compared with the general population. According to researchers, the cause of this difference is unclear at this time.
Additionally, CVD risk factors were increased in the MI group when compared with the general population, including angina (11.7% vs 0.4%), hypertension (10.6% vs 1.2%), diabetes (7.4% vs 1.1%) and obesity (4.6% vs 0.8%).
“Even though you survive a [MI] at an early age, you remain at an increased risk of another attack later in life. For the same reason, it is important that patients make efforts to reduce this long-term risk by adhering to the prescribed medical therapy by improving their lifestyle, especially by stopping smoking,” Schmidt said in the release. – by Dave Quaile
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts