Long-term outcome of patients presenting with myocardial injury or myocardial infarction

被引:3
|
作者
Haller, Paul M. [1 ,2 ]
Kellner, Caroline [1 ]
Soerensen, Nils A. [1 ,2 ]
Lehmacher, Jonas [1 ]
Toprak, Betuel [1 ,2 ]
Schock, Alina [1 ]
Hartikainen, Tau S. [3 ]
Twerenbold, Raphael [1 ,2 ,4 ]
Zeller, Tanja [1 ,2 ,4 ]
Westermann, Dirk [1 ,2 ,3 ]
Neumann, Johannes T. [1 ,2 ,5 ]
机构
[1] Univ Heart & Vasc Ctr Hamburg, Univ Med Ctr Hamburg Eppendorf, Dept Cardiol, Ctr Populat Hlth Innovat POINT, Bldg O50,Empore,Martinistr 52, D-20246 Hamburg, Germany
[2] DZHK, German Ctr Cardiovasc Res, Partner Site Hamburg,Kiel,Lubeck, Hamburg, Germany
[3] Univ Heart Ctr Freiburg Bad Krotzingen, Dept Cardiol, Bad Krotzingen, Germany
[4] Univ Heart & Vasc Ctr Hamburg, Univ Ctr Cardiovasc Sci, Hamburg, Germany
[5] Monash Univ, Sch Publ Hlth & Prevent Med, Dept Epidemiol & Prevent Med, Melbourne, Australia
关键词
High-sensitivity cardiac troponin; Myocardial infarction; Myocardial injury; Long-term outcome; Fourth UDMI; Acute coronary syndrome; SENSITIVITY CARDIAC TROPONIN; ASSOCIATION; ELEVATION; ESC;
D O I
10.1007/s00392-023-02334-w
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
AimsPatients with acute or chronic myocardial injury are frequently identified in the context of suspected myocardial infarction (MI). We aimed to investigate their long-term follow-up.Methods and resultsWe prospectively enrolled 2714 patients with suspected MI and followed them for all-cause mortality and a composite cardiovascular endpoint (CVE; cardiovascular death, MI, unplanned revascularization) for a median of 5.1 years. Final diagnoses were adjudicated by two cardiologists according to the Fourth Universal Definition of MI, including 143 (5.3%) ST-elevation MI, 236 (8.7%) non-ST-elevation MI (NSTEMI) Type 1 (T1), 128 (4.7%) NSTEMI T2, 86 (3.2%) acute and 677 (24.9%) with chronic myocardial injury, and 1444 (53.2%) with other reasons for chest pain (reference). Crude event rates per 1000 patient-years for all-cause mortality were highest in patients with myocardial injury (81.6 [71.7, 92.3]), and any type of MI (55.9 [46.3, 66.7]), compared to reference (12.2 [9.8, 15.1]). Upon adjustment, all diagnoses were significantly associated with all-cause mortality. Moreover, patients with acute (adj-HR 1.92 [1.08, 3.43]) or chronic (adj-HR 1.59 [1.16, 2.18]) myocardial injury, and patients with NSTEMI T1 (adj-HR 2.62 [1.85, 3.69]) and ST-elevation MI (adj-HR 3.66 [2.41, 5.57]) were at increased risk for cardiovascular events.ConclusionPatients with myocardial injury are at a similar increased risk for death and cardiovascular events compared to patients with acute MI. Further studies need to determine appropriate management strategies for patients with myocardial injury.RegistrationClinicaltrials.gov (NCT02355457).
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页数:9
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