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An EAPCI Expert Consensus Document on Ischaemia with Non-Obstructive Coronary Arteries in Collaboration with European Society of Cardiology Working Group on Coronary Pathophysiology & Microcirculation Endorsed by Coronary Vasomotor Disorders International Study Group Prevalence of Angina Among Primary Care Patients With Coronary Artery Disease Short term outcome following acute phase switch among P2Y12 inhibitors in patients presenting with acute coronary syndrome treated with PCI: A systematic review and meta-analysis including 22,500 patients from 14 studies Clinical and Angiographic Features of Patients With Out-of-Hospital Cardiac Arrest and Acute Myocardial Infarction A randomised trial comparing two stent sizing strategies in coronary bifurcation treatment with bioresorbable vascular scaffolds - The Absorb Bifurcation Coronary (ABC) trial Use of Mechanical Circulatory Support Devices Among Patients With Acute Myocardial Infarction Complicated by Cardiogenic Shock Culprit lesion location and outcome in patients with cardiogenic shock complicating myocardial infarction: a substudy of the IABP-SHOCK II-trial Association of Acute Procedural Results with Long-term Outcomes After CTO-PCI Risk Stratification Guided by the Index of Microcirculatory Resistance and Left Ventricular End-Diastolic Pressure in Acute Myocardial Infarction Letter by Jiang et al Regarding Article, “Direct Comparison of Cardiac Myosin-Binding Protein C With Cardiac Troponins for the Early Diagnosis of Acute Myocardial Infarction”
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Original ResearchEpub January 19, 2018

JOURNAL：Am J Cardiol. Article Link

Recurrent Cardiovascular Events in Survivors of Myocardial Infarction with St-Segment Elevation (From the AMI-QUEBEC Study)

T. Huynh, M. Montigny, U. Iftikhar et al. Keywords: Acute Myocardial Infarction, Acute Coronary Syndromes, Percutaneous Coronary Intervention, Reperfusion Therapy

ABSTRACT

The characteristics and predictors of long-term recurrent ischemic cardiovascular events (RICE) following myocardial infarction with ST-segment elevation (STEMI) have not yet been clarified. We aimed to characterize the 10-year incidence, types, and predictors of RICE. We obtained 10-year follow-up of STEMI survivors at 17 Quebec hospitals in Canada (the AMI-QUEBEC Study) in 2003. There were 858 patients; mean age of 60 years and 73% males. The majority of patients receive reperfusion therapy with 53.3% and 39.2% received primary PCI and fibrinolytic therapy, respectively. Seventy-five percent of patients underwent in-hospital PCI (elective, rescue and primary). At 10-year, 42% of patients suffered a RICE with most RICEs (88%) caused by recurrent cardiac ischemia. The risk of RICE was the highest during the first year (23.5 per person-year). At 10-year, the all-cause mortality was 19.3% with one-third of deaths being RICE-related. Prior CV event, heart failure during the index STEMI hospitalization, discharge prescription of calcium-blocker increased the risk of RICE by almost two-fold. Each point increase in Thrombolysis in Myocardial Infarction (TIMI) score augmented the risk of RICE by 6% while discharge prescription of dual anti-platelets reduced the risk of RICE by 23%. Our findings suggested that survivors of STEMI remain at high long-term risk of RICE despite high rate of reperfusion therapy and in-hospital PCI. Patients with prior CV event, in-hospital heart failure and high TIMI score were particularly susceptible to RICE. Future studies are needed to confirm the impacts of calcium-blocker and dual anti-platelets on long-term risk of RICE.
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