Key Points
- To assess five-year all-cause and coronary heart disease mortality and evaluate the prognostic impact of baseline risk factors, secondary prevention therapies, and revascularization procedures after a first acute myocardial infarction.
- Population-derived incident cohort study of 2,887 individuals presenting with a first acute myocardial infarction followed for up to five years.
- Evaluated baseline characteristics, pharmacological therapies, and revascularization procedures using logistic regression and survival analysis for short-term (<30 days) and longer-term (≥30 days) outcomes.
- Overall, 44.4% of patients died within five years, comprising 27.1% short-term (<30 days) and 23.7% longer-term (≥30 days) mortality.
- Longer-term coronary heart disease mortality was significantly reduced by percutaneous transluminal coronary angioplasty (AHR 0.49, 95% CI 0.26–0.93), β-blockers (AHR 0.58, 95% CI 0.46–0.74), and statins (AHR 0.60, 95% CI 0.47–0.77), though 8.7% received no secondary preventive therapy.
- Longer-term mortality risk significantly increased with diabetes (AHR 1.83, 95% CI 1.43–2.34), stroke (AHR 1.73, 95% CI 1.35–2.22), smoking (AHR 1.72, 95% CI 1.18–2.51), heart failure (AHR 1.69, 95% CI 1.28–2.22), and obesity (>30 kg/m²; AHR 1.39, 95% CI 1.01–1.90).
Structured PICO
Do PTCA, beta-blockers, and statins reduce mortality in patients after a first acute myocardial infarction?
PPopulation2,887 patients in a population-derived incident cohort presenting with a first acute myocardial infarction (AMI)
IInterventionPercutaneous transluminal coronary angioplasty (PTCA), beta-blockers, and statins
CComparatorPatients not receiving these specific interventions
OOutcomeCoronary heart disease (CHD) mortality and all-cause mortalityhard clinical
PTCA, beta-blockers, and statins are associated with significantly reduced long-term CHD mortality after a first AMI, reinforcing the importance of secondary prevention.