Younger STEMI patients treated with primary PCI had a 20-year overall survival of 50.6% and a relative survival rate of 79.5% compared to the general population.
Does primary percutaneous coronary intervention improve 20-year relative survival in younger patients with first STEMI compared to the general population?
Younger patients with a first STEMI treated by primary PCI have a 20-year relative survival rate of nearly 80% compared to the general population, with cardiovascular causes accounting for only half of the deaths.
Abstract Introduction Primary percutaneous coronary intervention (pPCI) is the gold standard of treatment in patients with ST elevation myocardial infarction (STEMI) for almost last two decades in Europe. Even though, short and middle-term outcomes are well known, few data exist about very long term mortality especially for younger patients with longer life expectancy. Aim To analyse 20 years mortality and relative survival rate compared to general population of younger patients (≤ 65 years) with first STEMI that had underwent pPCI. Methods We have performed analysis of the high-volume single centre registry of unselected patients that were treated for STEMI using pPCI between 1st January 2000 and 31st December 2002. Patients of age ≤ 65 years without previous history of myocardial infarction (MI) were selected. With cooperation of national Office of health and statistical information, data regarding mortality and cause of death (based on International diseases classification ICD - 10) were obtained (date of censoring 31 December 2023). Observed survival was determined by Kaplan-Meier method. Estimation of relative survival was determined by Pohar-Perme method with expected survival based on mortality tables for country population. Results Altogether, 911 patients (male sex 70.8%, n=645) with STEMI were treated by pPCI during 3 years period (2000-2002). Out of this study group, 385 patients (40.1%) were 65 years old without history of previous MI. The mean age for these patients at the time of STEMI was 55.03 ± 6.97 years in women (n=71) and 54.16 ± 6.85 years in men (n=314); p=0.168. During the whole follow-up period, 211 patients died (overall mortality 54.8%) and cardiovascular cause of death was identified in 111 patients (cardiovascular mortality 28.8%). The 20-year survival using Kaplan-Meier curve is shown in figure 1. The relative survival rate is shown in Figure2, respectively. The twenty year overall survival was 50.6% and the relative survival rate at 20 years was 79.5%. Conclusion Although we have observed a high overall 20-year mortality in patients after primary PCI, the relative 20-year survival rate compared to the general population is almost 80% in these patients. Furthermore, a cardiovascular cause of death was identified in only half of all deaths.Twenty-year survival, Kaplan-Meier curve Twenty years relative survival rate
Toušek et al. (2025) studied this question. Younger STEMI patients treated with primary PCI had a 20-year overall survival of 50.6% and a relative survival rate of 79.5% compared to the general population.