The relative impact of components of high residual risk on the long-term prognosis after AMI

• Published in: International journal of cardiology. Cardiovascular risk and prevention 2024-09, Vol.22, p.200310, Article 200310
• Main Authors: Mureddu, Gian Francesco, D'Errigo, Paola, Rosato, Stefano, Faggiano, Pompilio, Badoni, Gabriella, Ceravolo, Roberto, Altamura, Vito, Di Martino, Mirko, Ambrosetti, Marco, Oliva, Fabrizio, Ciccarelli, Paola, Baglio, Giovanni
• Format: Article
• Language: English
• Subjects: AMI; Heart failure; High residual risk; MACCE; Research Paper; Thrombotic risk
• ISSN: 2772-4875; 2772-4875
• DOI: 10.1016/j.ijcrp.2024.200310

The reduction in long-term mortality after acute myocardial infarction (AMI) is less pronounced than that of in-hospital mortality among patients with AMI complicated by heart failure (HF) and/or in those with a high residual thrombotic risk (HTR). To investigate the relative prognostic significance of HTR and HF in AMI survivors. This retrospective cohort study enrolled patients admitted for AMI in 2014–2015 in all Italian hospitals. HTR was defined as at least one of the following conditions: previous AMI, ischemic stroke or other vascular disease, type 2 diabetes, renal failure. Patients were classified into four categories: uncomplicated AMI; AMI with HTR; AMI with HF and AMI with both HTR and HF (HTR + HF). Cox proportional hazard model was used to evaluate the impact of HTR, HF and HTR + HF on the 5-year prognosis. A time-varying coefficient analysis was performed to estimate the 5-year trend of HR for major averse cardiac and cerebrovascular events (MACCE). a total of 174.869 AMI events were identified. The adjusted 5-year HR for MACCE was 1.74 (p