PDF(Pubmed)
Abstract：
UNASSIGNED: The reduction in long-term mortality after acute myocardial infarction (AMI) is less pronounced than that of in-hospital mortality among patients with AMI complicated by heart failure (HF) and/or in those with a high residual thrombotic risk (HTR).
UNASSIGNED: To investigate the relative prognostic significance of HTR and HF in AMI survivors.
UNASSIGNED: This retrospective cohort study enrolled patients admitted for AMI in 2014-2015 in all Italian hospitals. HTR was defined as at least one of the following conditions: previous AMI, ischemic stroke or other vascular disease, type 2 diabetes, renal failure. Patients were classified into four categories: uncomplicated AMI; AMI with HTR; AMI with HF and AMI with both HTR and HF (HTR + HF). Cox proportional hazard model was used to evaluate the impact of HTR, HF and HTR + HF on the 5-year prognosis. A time-varying coefficient analysis was performed to estimate the 5-year trend of HR for major averse cardiac and cerebrovascular events (MACCE).
UNASSIGNED: a total of 174.869 AMI events were identified. The adjusted 5-year HR for MACCE was 1.74 (p < 0.0001) and 1.75 (p < 0.0001) in HTR and HF patients vs uncomplicated patients, respectively. The coexistence of HTR and HF furtherly increased the risk of MACCE (HR = 2.43, p < 0.0001) over the first 3 years after AMI.
UNASSIGNED: Either HRT and HF confer an increased 5-year hazard of MACCE after AMI. The coexistence of HTR and HF doubled the overall 5-year risk of MACCE after AMI.
UNASSIGNED: To investigate the relative prognostic significance of HTR and HF in AMI survivors.
UNASSIGNED: This retrospective cohort study enrolled patients admitted for AMI in 2014-2015 in all Italian hospitals. HTR was defined as at least one of the following conditions: previous AMI, ischemic stroke or other vascular disease, type 2 diabetes, renal failure. Patients were classified into four categories: uncomplicated AMI; AMI with HTR; AMI with HF and AMI with both HTR and HF (HTR + HF). Cox proportional hazard model was used to evaluate the impact of HTR, HF and HTR + HF on the 5-year prognosis. A time-varying coefficient analysis was performed to estimate the 5-year trend of HR for major averse cardiac and cerebrovascular events (MACCE).
UNASSIGNED: a total of 174.869 AMI events were identified. The adjusted 5-year HR for MACCE was 1.74 (p < 0.0001) and 1.75 (p < 0.0001) in HTR and HF patients vs uncomplicated patients, respectively. The coexistence of HTR and HF furtherly increased the risk of MACCE (HR = 2.43, p < 0.0001) over the first 3 years after AMI.
UNASSIGNED: Either HRT and HF confer an increased 5-year hazard of MACCE after AMI. The coexistence of HTR and HF doubled the overall 5-year risk of MACCE after AMI.
摘要：
■急性心肌梗死（AMI）后的长期死亡率的降低不如AMI并发心力衰竭（HF）和/或具有高残余血栓形成风险（HTR）的患者的院内死亡率明显。
■探讨HTR和HF在AMI幸存者中的相对预后意义。
■这项回顾性队列研究纳入了2014-2015年意大利所有医院的AMI患者。HTR被定义为以下至少一种情况：以前的AMI，缺血性中风或其他血管疾病，2型糖尿病,肾功能衰竭.患者分为四类：无并发症的AMI；带有HTR的AMI；带有HF的AMI和带有HTR和HF的AMI（HTRHF）。Cox比例风险模型用于评估HTR的影响，HF和HTR+HF对5年预后的影响。进行了时变系数分析，以估计主要不良心脑血管事件（MACCE）的5年HR趋势。
■共发现174.869例AMI事件。HTR和HF患者与无并发症患者相比，MACCE的校正5年HR分别为1.74（p<0.0001）和1.75（p<0.0001）。分别。在AMI后的前3年内，HTR和HF的共存进一步增加了MACCE的风险（HR=2.43，p<0.0001）。
■HRT和HF均可在AMI后增加MACCE的5年风险。HTR和HF的共存使AMI后5年MACCE的总体风险增加了一倍。
■探讨HTR和HF在AMI幸存者中的相对预后意义。
■这项回顾性队列研究纳入了2014-2015年意大利所有医院的AMI患者。HTR被定义为以下至少一种情况：以前的AMI，缺血性中风或其他血管疾病，2型糖尿病,肾功能衰竭.患者分为四类：无并发症的AMI；带有HTR的AMI；带有HF的AMI和带有HTR和HF的AMI（HTRHF）。Cox比例风险模型用于评估HTR的影响，HF和HTR+HF对5年预后的影响。进行了时变系数分析，以估计主要不良心脑血管事件（MACCE）的5年HR趋势。
■共发现174.869例AMI事件。HTR和HF患者与无并发症患者相比，MACCE的校正5年HR分别为1.74（p<0.0001）和1.75（p<0.0001）。分别。在AMI后的前3年内，HTR和HF的共存进一步增加了MACCE的风险（HR=2.43，p<0.0001）。
■HRT和HF均可在AMI后增加MACCE的5年风险。HTR和HF的共存使AMI后5年MACCE的总体风险增加了一倍。
