Short- and Long-Term Cause of Death in Patients Treated With Primary PCI for STEMI

Frants Pedersen; Vitalij Butrymovich; Henning Kelbæk; Kristian Wachtell; Steffen Helqvist; Jens Kastrup; Lene Holmvang; Peter Clemmensen; Thomas Engstrøm; Peer Grande; Kari Saunamäki; Erik Jørgensen

doi:10.1016/j.jacc.2014.08.037

Short- and Long-Term Cause of Death in Patients Treated With Primary PCI for STEMI

Frants Pedersen, Vitalij Butrymovich, Henning Kelbæk, Kristian Wachtell, Steffen Helqvist, Jens Kastrup, Lene Holmvang, Peter Clemmensen, Thomas Engstrøm, Peer Grande, Kari Saunamäki, Erik Jørgensen

181 Citations (Scopus)

Abstract

BACKGROUND Short-term mortality has been studied thoroughly in patients undergoing primary percutaneous coronary intervention (PCI), whereas long-term cause of death in patients with ST-segment elevation myocardial infarction (STEMI) remains unknown. OBJECTIVES The goal of this study was to describe the association between time and cause of death in patients with STEMI undergoing primary PCI. METHODS A centralized civil registration system, patient files, and public disease and death cause registries with an accurate record linkage were used to trace time and cause of death in 2,804 consecutive patients with STEMI (age 63 ± 13 years, 72% males) treated with primary PCI. RESULTS Patients were followed up for a median of 4.7 years. During a total of 13,447 patient-years, 717 patients died. Main causes of death within the first 30 days were cardiogenic shock and anoxic brain injury after cardiac arrest. Age, culprit vessel size and flow, and the presence of heart failure and diabetes were independent predictors of mortality. After 30 days, the annual cardiac mortality rate was <1.5%. Causes of death beyond 30 days were noncardiac in 65% of cases (mainly malignancies and pulmonary diseases). The 30-day, 1-year, and 5-year all-cause (and cardiac) mortality rates were 7.9% (7.3%), 11.4% (8.4%), and 23.3% (13.8%), respectively. CONCLUSIONS Patients who survive the first month after an STEMI treated with primary PCI have an excellent prognosis, with a <1.5% annual risk of successive cardiac death. Noncardiac causes are responsible for the majority of later deaths in these patients.

Original language	English
Journal	Journal of the American College of Cardiology
Volume	64
Issue number	20
Pages (from-to)	2101-2108
Number of pages	8
ISSN	0735-1097
DOIs	https://doi.org/10.1016/j.jacc.2014.08.037
Publication status	Published - 3 Dec 2014

Keywords

Aged
Cause of Death
Female
Humans
Male
Middle Aged
Myocardial Infarction
Percutaneous Coronary Intervention
Registries
Risk Factors
Time Factors

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jacc.2014.08.037

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Pedersen, F., Butrymovich, V., Kelbæk, H., Wachtell, K., Helqvist, S., Kastrup, J., Holmvang, L., Clemmensen, P., Engstrøm, T., Grande, P., Saunamäki, K., & Jørgensen, E. (2014). Short- and Long-Term Cause of Death in Patients Treated With Primary PCI for STEMI. Journal of the American College of Cardiology, 64(20), 2101-2108. https://doi.org/10.1016/j.jacc.2014.08.037

Pedersen, F, Butrymovich, V, Kelbæk, H, Wachtell, K, Helqvist, S, Kastrup, J, Holmvang, L, Clemmensen, P, Engstrøm, T, Grande, P, Saunamäki, K & Jørgensen, E 2014, 'Short- and Long-Term Cause of Death in Patients Treated With Primary PCI for STEMI', Journal of the American College of Cardiology, vol. 64, no. 20, pp. 2101-2108. https://doi.org/10.1016/j.jacc.2014.08.037

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abstract = "BACKGROUND Short-term mortality has been studied thoroughly in patients undergoing primary percutaneous coronary intervention (PCI), whereas long-term cause of death in patients with ST-segment elevation myocardial infarction (STEMI) remains unknown. OBJECTIVES The goal of this study was to describe the association between time and cause of death in patients with STEMI undergoing primary PCI. METHODS A centralized civil registration system, patient files, and public disease and death cause registries with an accurate record linkage were used to trace time and cause of death in 2,804 consecutive patients with STEMI (age 63 ± 13 years, 72% males) treated with primary PCI. RESULTS Patients were followed up for a median of 4.7 years. During a total of 13,447 patient-years, 717 patients died. Main causes of death within the first 30 days were cardiogenic shock and anoxic brain injury after cardiac arrest. Age, culprit vessel size and flow, and the presence of heart failure and diabetes were independent predictors of mortality. After 30 days, the annual cardiac mortality rate was <1.5%. Causes of death beyond 30 days were noncardiac in 65% of cases (mainly malignancies and pulmonary diseases). The 30-day, 1-year, and 5-year all-cause (and cardiac) mortality rates were 7.9% (7.3%), 11.4% (8.4%), and 23.3% (13.8%), respectively. CONCLUSIONS Patients who survive the first month after an STEMI treated with primary PCI have an excellent prognosis, with a <1.5% annual risk of successive cardiac death. Noncardiac causes are responsible for the majority of later deaths in these patients.",

keywords = "Aged, Cause of Death, Female, Humans, Male, Middle Aged, Myocardial Infarction, Percutaneous Coronary Intervention, Registries, Risk Factors, Time Factors",

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doi = "10.1016/j.jacc.2014.08.037",

language = "English",

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T1 - Short- and Long-Term Cause of Death in Patients Treated With Primary PCI for STEMI

AU - Pedersen, Frants

AU - Butrymovich, Vitalij

AU - Kelbæk, Henning

AU - Wachtell, Kristian

AU - Helqvist, Steffen

AU - Kastrup, Jens

AU - Holmvang, Lene

AU - Clemmensen, Peter

AU - Engstrøm, Thomas

AU - Grande, Peer

AU - Saunamäki, Kari

AU - Jørgensen, Erik

PY - 2014/12/3

Y1 - 2014/12/3

N2 - BACKGROUND Short-term mortality has been studied thoroughly in patients undergoing primary percutaneous coronary intervention (PCI), whereas long-term cause of death in patients with ST-segment elevation myocardial infarction (STEMI) remains unknown. OBJECTIVES The goal of this study was to describe the association between time and cause of death in patients with STEMI undergoing primary PCI. METHODS A centralized civil registration system, patient files, and public disease and death cause registries with an accurate record linkage were used to trace time and cause of death in 2,804 consecutive patients with STEMI (age 63 ± 13 years, 72% males) treated with primary PCI. RESULTS Patients were followed up for a median of 4.7 years. During a total of 13,447 patient-years, 717 patients died. Main causes of death within the first 30 days were cardiogenic shock and anoxic brain injury after cardiac arrest. Age, culprit vessel size and flow, and the presence of heart failure and diabetes were independent predictors of mortality. After 30 days, the annual cardiac mortality rate was <1.5%. Causes of death beyond 30 days were noncardiac in 65% of cases (mainly malignancies and pulmonary diseases). The 30-day, 1-year, and 5-year all-cause (and cardiac) mortality rates were 7.9% (7.3%), 11.4% (8.4%), and 23.3% (13.8%), respectively. CONCLUSIONS Patients who survive the first month after an STEMI treated with primary PCI have an excellent prognosis, with a <1.5% annual risk of successive cardiac death. Noncardiac causes are responsible for the majority of later deaths in these patients.

AB - BACKGROUND Short-term mortality has been studied thoroughly in patients undergoing primary percutaneous coronary intervention (PCI), whereas long-term cause of death in patients with ST-segment elevation myocardial infarction (STEMI) remains unknown. OBJECTIVES The goal of this study was to describe the association between time and cause of death in patients with STEMI undergoing primary PCI. METHODS A centralized civil registration system, patient files, and public disease and death cause registries with an accurate record linkage were used to trace time and cause of death in 2,804 consecutive patients with STEMI (age 63 ± 13 years, 72% males) treated with primary PCI. RESULTS Patients were followed up for a median of 4.7 years. During a total of 13,447 patient-years, 717 patients died. Main causes of death within the first 30 days were cardiogenic shock and anoxic brain injury after cardiac arrest. Age, culprit vessel size and flow, and the presence of heart failure and diabetes were independent predictors of mortality. After 30 days, the annual cardiac mortality rate was <1.5%. Causes of death beyond 30 days were noncardiac in 65% of cases (mainly malignancies and pulmonary diseases). The 30-day, 1-year, and 5-year all-cause (and cardiac) mortality rates were 7.9% (7.3%), 11.4% (8.4%), and 23.3% (13.8%), respectively. CONCLUSIONS Patients who survive the first month after an STEMI treated with primary PCI have an excellent prognosis, with a <1.5% annual risk of successive cardiac death. Noncardiac causes are responsible for the majority of later deaths in these patients.

KW - Aged

KW - Cause of Death

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Myocardial Infarction

KW - Percutaneous Coronary Intervention

KW - Registries

KW - Risk Factors

KW - Time Factors

U2 - 10.1016/j.jacc.2014.08.037

DO - 10.1016/j.jacc.2014.08.037

M3 - Journal article

C2 - 25457398

SN - 0735-1097

VL - 64

SP - 2101

EP - 2108

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

IS - 20

ER -

Short- and Long-Term Cause of Death in Patients Treated With Primary PCI for STEMI

Abstract

Keywords

UN SDGs

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