Culprit and nonculprit recurrent ischemic events in patients with myocardial infarction: Data from SWEDEHEART (Swedish Web System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies)

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Culprit and nonculprit recurrent ischemic events in patients with myocardial infarction : Data from SWEDEHEART (Swedish Web System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies). / Varenhorst, Christoph; Hasvold, Pål; Johansson, Saga; Janzon, Magnus; Albertsson, Per; Leosdottir, Margret; Hambraeus, Kristina; James, Stefan; Jernberg, Tomas; Svennblad, Bodil; Lagerqvist, Bo.

I: Journal of the American Heart Association, Vol. 7, Nr. 1, e007174, 01.01.2018.

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Varenhorst, Christoph ; Hasvold, Pål ; Johansson, Saga ; Janzon, Magnus ; Albertsson, Per ; Leosdottir, Margret ; Hambraeus, Kristina ; James, Stefan ; Jernberg, Tomas ; Svennblad, Bodil ; Lagerqvist, Bo. / Culprit and nonculprit recurrent ischemic events in patients with myocardial infarction : Data from SWEDEHEART (Swedish Web System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies). I: Journal of the American Heart Association. 2018 ; Vol. 7, Nr. 1.

RIS

TY - JOUR

T1 - Culprit and nonculprit recurrent ischemic events in patients with myocardial infarction

T2 - Data from SWEDEHEART (Swedish Web System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies)

AU - Varenhorst, Christoph

AU - Hasvold, Pål

AU - Johansson, Saga

AU - Janzon, Magnus

AU - Albertsson, Per

AU - Leosdottir, Margret

AU - Hambraeus, Kristina

AU - James, Stefan

AU - Jernberg, Tomas

AU - Svennblad, Bodil

AU - Lagerqvist, Bo

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background--Long-term disease progression after myocardial infarction (MI) is inadequately understood. We evaluated the pattern and angiographic properties (culprit lesion [CL]/non-CL [NCL]) of recurrent MI (re-MI) in a large real-world patient population. Methods and Results--Our observational study used prospectively collected data in 108 615 patients with first-occurrence MI enrolled in the SWEDEHEART (Swedish Web System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies) between July 1, 2006 and November 29, 2014. During follow-up (median, 3.2 years), recurrent hospitalization for MI occurred in 11 117 patients (10.2%). Of the patients who underwent coronary angiography for the index MI, a CL was identified in 44 332 patients. Of those patients, 3464 experienced an re-MI; the infarct originated from the NCL in 1243 patients and from the CL in 655 patients. In total, 1566 re-MIs were indeterminate events and could not be classified as NCL or CL re-MIs. The risk of re-MI within 8 years related to the NCL was 0.06 (95% confidence interval [CI], 0.05-0.06), compared with 0.03 (95% CI, 0.02-0.03) for the CL. There were no large differences in baseline characteristics of patients with subsequent NCL versus CL re-MIs. Independent predictors of NCL versus CL re- MI were multivessel disease (odds ratio, 2.29; 95% CI, 1.87-2.82), male sex (odds ratio, 1.36; 95% CI, 1.09-1.71), and a prolonged time between the index and re-MI (odds ratio, 1.16; 95% CI, 1.10- 1.22). Conclusions--In a large cohort of patients with first-occurrence MI undergoing percutaneous coronary intervention, the risk of re-MI originating from a previously untreated lesion was twice higher than the risk of lesions originating from a previously stented lesion.

AB - Background--Long-term disease progression after myocardial infarction (MI) is inadequately understood. We evaluated the pattern and angiographic properties (culprit lesion [CL]/non-CL [NCL]) of recurrent MI (re-MI) in a large real-world patient population. Methods and Results--Our observational study used prospectively collected data in 108 615 patients with first-occurrence MI enrolled in the SWEDEHEART (Swedish Web System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies) between July 1, 2006 and November 29, 2014. During follow-up (median, 3.2 years), recurrent hospitalization for MI occurred in 11 117 patients (10.2%). Of the patients who underwent coronary angiography for the index MI, a CL was identified in 44 332 patients. Of those patients, 3464 experienced an re-MI; the infarct originated from the NCL in 1243 patients and from the CL in 655 patients. In total, 1566 re-MIs were indeterminate events and could not be classified as NCL or CL re-MIs. The risk of re-MI within 8 years related to the NCL was 0.06 (95% confidence interval [CI], 0.05-0.06), compared with 0.03 (95% CI, 0.02-0.03) for the CL. There were no large differences in baseline characteristics of patients with subsequent NCL versus CL re-MIs. Independent predictors of NCL versus CL re- MI were multivessel disease (odds ratio, 2.29; 95% CI, 1.87-2.82), male sex (odds ratio, 1.36; 95% CI, 1.09-1.71), and a prolonged time between the index and re-MI (odds ratio, 1.16; 95% CI, 1.10- 1.22). Conclusions--In a large cohort of patients with first-occurrence MI undergoing percutaneous coronary intervention, the risk of re-MI originating from a previously untreated lesion was twice higher than the risk of lesions originating from a previously stented lesion.

KW - Culprit artery

KW - Myocardial infarction

KW - Nonculprit artery

KW - Percutaneous coronary intervention

KW - Prognosis

UR - http://www.scopus.com/inward/record.url?scp=85040527025&partnerID=8YFLogxK

U2 - 10.1161/JAHA.117.007174

DO - 10.1161/JAHA.117.007174

M3 - Article

AN - SCOPUS:85040527025

VL - 7

JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

SN - 2047-9980

IS - 1

M1 - e007174

ER -