Fiche publication


Date publication

mars 2017

Journal

The American journal of cardiology

Auteurs

Membres identifiés du Cancéropôle Est :
Pr COTTIN Yves


Tous les auteurs :
Puymirat E, Aissaoui N, Lemesle G, Cottin Y, Coste P, Schiele F, Ferrières J, Simon T, Danchin N,

Résumé

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.

Mots clés

Adrenergic beta-Antagonists, therapeutic use, Age Distribution, Aged, Aged, 80 and over, Angiotensin Receptor Antagonists, therapeutic use, Angiotensin-Converting Enzyme Inhibitors, therapeutic use, Atherosclerosis, epidemiology, Case-Control Studies, Cause of Death, Cerebrovascular Disorders, epidemiology, Coronary Artery Bypass, Coronary Artery Disease, epidemiology, Female, France, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors, therapeutic use, Longitudinal Studies, Male, Middle Aged, Mortality, Multivariate Analysis, Myocardial Infarction, epidemiology, Percutaneous Coronary Intervention, Platelet Aggregation Inhibitors, therapeutic use, Prognosis, Proportional Hazards Models, Prospective Studies, Registries, Risk Factors, Treatment Outcome

Référence

Am. J. Cardiol.. 2017 Mar;119(5):692-697