In stable post-STEMI patients, age ≥80 years (HR 3.16), EF <40% (HR 2.32), diabetes (HR 1.49), and 3-vessel CAD (HR 1.44) were identified as significant predictors of 8-year MACE.
Cohort (n=3,079)
What are the predictors of major adverse cardiovascular events in stable patients after ST elevation myocardial infarction?
Age >60 years, EF <50%, diabetes mellitus, and 3-vessel coronary artery disease are significant predictors of 8-year MACE in stable post-STEMI patients, suggesting a need for personalized secondary prevention.
BACKGROUND/AIM: The aim of this study was to determine predictors of major adverse cardiovascular events, including MACE (mortality, non-fatal recurrent infarction, non-fatal stroke, and target vessel revascularization-TVR) in stable post-STEMI patients. METHOD: We analyzed STEMI patients without cardiogenic shock at admission included in our STEMI Register. The patients were treated with primary PCI. The follow-up period was eight years. RESULTS: From 1 December 2006 to 31 December 2016, a total of 3079 patients were included in the Register. In the first year, MACE was registered in 348 (11.3%) patients. The remaining patients were considered stable. They were included in further analysis. At eight years, the rates were as follows: MACE 3.9%, non-fatal recurrent infarction 2.1%, TVR 1.8%, non-fatal stroke 0.5%, and mortality 2.1%. Predictors for 8-year MACE were age >60 years (60-69 vs. <60 years HR 1.65; 70-79 vs. <60 years HR 1.82; ≥80 vs. <60 years HR 3.16), EF < 50% (EF 40-49% HR 2.38; EF < 40% HR 2.32), diabetes mellitus (HR 1.49), and 3-vessel coronary artery disease (HR 1.44). CONCLUSIONS: Four predictors identified stable post-STEMI patients who remained at a higher risk for the occurrence of MACE. Stable post-STEMI patients with one or more of these risk factors may require more aggressive secondary prevention measures or a personalized approach to improve their prognosis.
Savić et al. (Fri,) conducted a cohort in Stable post-STEMI (n=3,079). Risk factors (age >60, EF <50%, diabetes, 3-vessel CAD) vs. Absence of risk factors was evaluated on MACE (mortality, non-fatal recurrent infarction, non-fatal stroke, and target vessel revascularization). In stable post-STEMI patients, age ≥80 years (HR 3.16), EF <40% (HR 2.32), diabetes (HR 1.49), and 3-vessel CAD (HR 1.44) were identified as significant predictors of 8-year MACE.