Survival after hospital discharge for ST-segment elevation and non-ST-segment elevation acute myocardial infarction: a population-based study
Authors
Darling, Chad E.Fisher, Kimberly A.
McManus, David D.
Coles, Andrew H.
Spencer, Frederick A.
Gore, Joel M.
Goldberg, Robert J.
UMass Chan Affiliations
Meyers Primary Care InstituteProgram for Gene Function and Expression
Department of Medicine, Division of Cardiovascular Medicine
Department of Medicine, Division of Pulmonary Critical Care
Department of Quantitative Health Sciences
Department of Emergency Medicine
Document Type
Journal ArticlePublication Date
2013-07-22
Metadata
Show full item recordAbstract
BACKGROUND: Limited recent data are available describing differences in long-term survival, and factors affecting prognosis, after ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI), especially from the more generalizable perspective of a population-based investigation. The objectives of this study were to examine differences in post-discharge prognosis after hospitalization for STEMI and NSTEMI, with a particular focus on factors associated with reduced long-term survival. METHODS: We reviewed the medical records of residents of the Worcester, MA, USA metropolitan area hospitalized at eleven central Massachusetts medical centers for acute myocardial infarction (AMI) during 2001, 2003, 2005, and 2007. RESULTS: A total of 3762 persons were hospitalized with confirmed AMI; of these, 2539 patients (67.5%) were diagnosed with NSTEMI. The average age of study patients was 70.3 years and 42.9% were women. Patients with NSTEMI experienced higher post-discharge death rates with 3-month, 1-year, and 2-year death rates of 12.6%, 23.5%, and 33.2%, respectively, compared to 6.1%, 11.5%, and 16.4% for patients with STEMI. After multivariable adjustment, patients with NSTEMI were significantly more likely to have died after hospital discharge (adjusted hazards ratio 1.28; 95% confidence interval 1.14-1.44). Several demographic (eg, older age) and clinical (eg, history of stroke) factors were associated with reduced long-term survival in patients with NSTEMI and STEMI. CONCLUSIONS: The results of this study in residents of central Massachusetts suggest that patients with NSTEMI are at higher risk for dying after hospital discharge, and several subgroups are at particularly increased risk.Source
Clin Epidemiol. 2013 Jul 22;5:229-36. doi: 10.2147/CLEP.S45646. Print 2013. Link to article on publisher's siteDOI
10.2147/CLEP.S45646Permanent Link to this Item
http://hdl.handle.net/20.500.14038/30226PubMed ID
23901296Related Resources
Link to Article in PubMedDistribution License
http://creativecommons.org/licenses/by-nc/3.0/ae974a485f413a2113503eed53cd6c53
10.2147/CLEP.S45646
Scopus Count
Except where otherwise noted, this item's license is described as http://creativecommons.org/licenses/by-nc/3.0/