Effect of comorbidity on coronary reperfusion strategy and long-term mortality after acute myocardial infarction

American Heart Journal
Daniela BalziAMI-Florence Working Group

Abstract

Chronic comorbidity is a prognostic determinant in ST-segment elevation myocardial infarction (STEMI). This study was aimed at determining to what extent this effect is independent or derives from adoption of different therapeutic strategies. Seven hundred forty patients with STEMI hospitalized within 12 hours of symptom onset were enrolled in a population-based registry, in a health district comprising 1 teaching hospital with and 5 district hospitals without percutaneous coronary intervention (PCI) facilities. Three categories of increasing chronic comorbidity score (CS-1, n = 259; CS-2, n = 235; CS-3, n = 246) were identified from age-adjusted associations of comorbidities with 1-year survival. Higher CS was associated with lower direct admission or transferal rates to hospital with PCI. Coronary reperfusion therapy (PCI in 91.5% of 470 cases) was adopted less frequently (P < .001) in CS-3 (41.9%) than CS-2 (69.4%) or CS-1 (78.8%). Compared with conservative therapy (n = 270), reperfusion therapy reduced 1-year mortality in the whole series not significantly (P = .816) in CS-1 but significantly in CS-2 (P = .012) and CS-3 (P = .001). This trend persisted after adjusting for age, Killip class, and acute myocardial infarction ...Continue Reading

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Citations

Aug 24, 2012·Journal of Geriatric Cardiology : JGC·Marc-Alexander OhlowBernward Lauer
May 28, 2014·Heart·Mauro Di BariUNKNOWN Acute Myocardial Infarction in Florence 2 (AMI Florence-2) Working Group
Feb 15, 2008·Internal and Emergency Medicine·Daniela BalziUNKNOWN AMI-Florence Working Group
Sep 7, 2013·Chest·Carlo NozzoliLeonardo M Fabbri
Jul 8, 2016·Scandinavian Cardiovascular Journal : SCJ·Matilde Winther-JensenChristian Hassager
Jul 10, 2012·Journal of Cardiovascular Medicine·Alessandro BarchielliNiccolò Marchionni
Jan 25, 2017·Human Vaccines & Immunotherapeutics·Aurélien JamotteYadira Isaza de Molto
Mar 23, 2017·International Heart Journal·Mohamed GayedMarc-Alexander Ohlow
Oct 13, 2018·Geriatrics & Gerontology International·Alice BreiningJacques Boddaert
May 12, 2021·International Journal of Clinical Practice·Fangyuan ZhangMamas A Mamas

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