Recent Drop in Post-Discharge Mortality After Acute MI
(HealthDay News) – For patients with acute myocardial infarction (AMI), post-discharge mortality rates decreased from 2001 to 2007, according to a study published in the Oct. 15 issue of The American Journal of Cardiology.
Andrew H. Coles, Ph.D., of the University of Massachusetts Medical School in Worcester, and colleagues conducted a population-based study of 2,452 patients (mainly older, male, and white) treated for initial AMI at 11 central Massachusetts medical centers in 2001, 2003, 2005, and 2007. The authors sought to examine factors associated with poor prognosis.
The researchers found that the three-month, one-year, and two-year all-cause mortality rates were 8.9, 16.4, and 23.4 percent, respectively, overall. In crude and multivariate-adjusted analyses, there was a reduction in the post-discharge mortality over time. The rates at three months, one year, and two years were 11.1, 17.1, and 25.6, respectively, in 2001, and decreased to 7.9, 12.7, and 18.6 percent for patients discharged in 2007. An increased risk of death after discharge was associated with older age, male gender, hospitalization for a non-ST-segment elevation AMI, renal dysfunction, and preexisting heart failure.
"These results suggest that the post-discharge prognosis of patients with initial AMIs has improved, likely reflecting enhanced in-hospital and post-discharge management practices," the authors write. "Patients with initial AMIs can also be identified who are at increased risk for dying after hospital discharge, in whom increased surveillance and targeted treatment approaches can be directed."