Predictors and prognostic impact of recurrent myocardial infarction in patients with left ventricular dysfunction, heart failure, or both following a first myocardial infarction
Journal article
Thune, Jens Jakob, Signorovitch, James E., Kober, Lars, McMurray, John J. V., Swedberg, Karl, Rouleau, Jean L., Maggioni, Aldo Pietro, Velazquez, Eric J., Califf, Robert M., Pfeffer, Marc A. and Solomon, Scott D.. (2011). Predictors and prognostic impact of recurrent myocardial infarction in patients with left ventricular dysfunction, heart failure, or both following a first myocardial infarction. European Journal of Heart Failure. 13(2), pp. 148 - 153. https://doi.org/10.1093/eurjhf/hfq194
Authors | Thune, Jens Jakob, Signorovitch, James E., Kober, Lars, McMurray, John J. V., Swedberg, Karl, Rouleau, Jean L., Maggioni, Aldo Pietro, Velazquez, Eric J., Califf, Robert M., Pfeffer, Marc A. and Solomon, Scott D. |
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Abstract | Aims: Recurrent myocardial infarction ( MI ) is common after a first MI and is associated with increased morbidity and mortality. Predictors and prognosis of a recurrent MI with contemporary management are not well known. Methods and results: We assessed the predictors and prognostic impact of a first recurrent MI in 10 599 patients with left ventricular dysfunction, heart failure, or both following a first MI from the Valsartan in Acute Myocardial Infarction Trial ( VALIANT ) cohort. During a median follow-up of 27.4 months, 861 patients ( 9.6% ) had a recurrent MI. The median time to recurrence was 136 days ( quartiles 35–361 days ), with a declining rate of recurrent MI within the first 3 months. The strongest predictors of recurrent MI were reduced estimated glomerular filtration rate, unstable angina, diabetes, and age. Mortality was markedly elevated ( 20.5% ) within the first 7 days of a recurrent MI. Patients who survived 7 days after a recurrent MI continued to be at increased risk of death compared with patients without a recurrent MI and the risk of death remained elevated more than two-fold a year after the recurrent MI ( adjusted hazards ratio 2.4, 95% confidence interval 1.7–3.2 ). One-year mortality for the entire VALIANT cohort was 10.3%, whereas 38.3% of the patients were dead 1 year after recurrent MI. Early reinfarctions ( within 1 month ) was associated with significantly higher 30-day mortality than later reinfarctions. Conclusion: Even in the context of contemporary treatment, a recurrent MI confers a significantly increased risk of death in patients following a high-risk first MI. Strategies aimed at reducing recurrent MI will thus likely prolong survival in post-MI survivors. |
Keywords | myocardial infarction; mortality; epidemiology |
Year | 2011 |
Journal | European Journal of Heart Failure |
Journal citation | 13 (2), pp. 148 - 153 |
Publisher | John Wiley & Sons Ltd |
ISSN | 1388-9842 |
Digital Object Identifier (DOI) | https://doi.org/10.1093/eurjhf/hfq194 |
Scopus EID | 2-s2.0-79551499429 |
Page range | 148 - 153 |
Research Group | Mary MacKillop Institute for Health Research |
Publisher's version | File Access Level Controlled |
Place of publication | United Kingdom |
https://acuresearchbank.acu.edu.au/item/89z50/predictors-and-prognostic-impact-of-recurrent-myocardial-infarction-in-patients-with-left-ventricular-dysfunction-heart-failure-or-both-following-a-first-myocardial-infarction
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