Key Points
- To evaluate shifts in long-term mortality and medication patterns among patients surviving acute myocardial infarction across different time cohorts.
- Comparison between the retrospective-prospective LIS registry (2005–2007) and the prospective LIS-3 registry (patients admitted with acute coronary syndrome with or without ST elevation in 2014 and 2018, N=327).
- Vital status and causes of death were assessed via phone contact starting ≥1 year post-discharge and cross-referenced with polyclinic archives and statistical databases.
- Evaluated differences in clinical characteristics, pre-hospital drug therapy, and post-discharge pharmacological regimens between registry cohorts.
- Significant differences were observed when comparing long-term mortality curves between the historical LIS and modern LIS-3 cohorts.
- Pre-hospital medication usage increased in the LIS-3 cohort for antiplatelets (20% vs 16%) and statins (11.6% vs 2.0%), while pre-hospital diuretic prescriptions declined.
- Discharge prescriptions in LIS-3 vs LIS showed substantial increases in guideline-directed medical therapy: antiplatelets (97.5% vs 85.0%), statins (96.5% vs 67.0%), beta-blockers (93.3% vs 81.0%), and anticoagulants (1.1% vs 0%).
Structured PICO
Does contemporary management of acute myocardial infarction improve long-term mortality compared to historical management?
PPopulationPatients discharged after acute myocardial infarction (AMI) from the Lyubertsy District Hospital in 2005-2007 (LIS registry) and in 2014 and 2018 (LIS-3 registry, n=327).
IInterventionContemporary post-AMI management and secondary prevention (2014 and 2018 period, LIS-3 registry).
CComparatorHistorical post-AMI management and secondary prevention (2005-2007 period, LIS registry).
OOutcomeLong-term mortality.hard clinical
Long-term mortality after myocardial infarction significantly decreased over a 10-15 year period, coinciding with increased utilization of guideline-directed medical therapies such as statins, antiplatelets, and beta-blockers.