Long-Term Clinical Outcomes According to Previous Manifestations of Atherosclerotic Disease (from the FAST-MI 2010 Registry)

Etienne Puymirat, Nadia Aissaoui, Gilles Lemesle, Yves Cottin, Pierre Coste, François Schiele, Jean Ferrières, Tabassome Simon, Nicolas Danchin

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Abstract

The prognosis of patients with acute myocardial infarction (AMI) has notably improved in the past 20 years. Using the French Registry of ST-Elevation and Non-ST-elevation Myocardial Infarction (FAST-MI) 2010 registry, we investigated whether previous manifestations of atherosclerotic disease (i.e., previous MI, or a history of any form of atherosclerotic disease) are at truly increased risk compared with those in whom AMI is the first manifestation of the disease. FAST-MI 2010 is a nationwide French registry including 3,079 patients with AMI, among whom 1,062 patients had a history of cardiovascular atherosclerotic disease and 498 patients had a history of MI. Overall, patients with a history of atherosclerotic disease (or MI) were older compared with patients without known cardiovascular disease (71 ± 13 vs 63 ± 14 years) and had higher cardiovascular risk profiles and co-morbidities. Using fully adjusted Cox multivariate analysis, previous manifestations of atherosclerotic disease were associated with higher 3-year mortality (hazard ratio 1.80, 95% confidence interval 1.40 to 2.31; p <0.001) as history of previous MI alone (hazard ratio 1.32, 95% confidence interval 1.00 to 1.73; p = 0.048). Similar results were found in patients discharged alive. In conclusion, previous cardiovascular atherosclerotic disease represents 1/3 of patients with AMI and are strongly associated with worse long-term clinical outcomes. Intensive follow-up and therapy should be encouraged in this high-risk population.

Original languageEnglish (US)
Pages (from-to)692-697
Number of pages6
JournalAmerican Journal of Cardiology
Volume119
Issue number5
DOIs
StatePublished - Mar 1 2017

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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    Puymirat, E., Aissaoui, N., Lemesle, G., Cottin, Y., Coste, P., Schiele, F., Ferrières, J., Simon, T., & Danchin, N. (2017). Long-Term Clinical Outcomes According to Previous Manifestations of Atherosclerotic Disease (from the FAST-MI 2010 Registry). American Journal of Cardiology, 119(5), 692-697. https://doi.org/10.1016/j.amjcard.2016.11.032