Journal of Clinical Medicine (Nov 2021)

Temporal Trends and Outcome of Patients with Acute Coronary Syndrome and Prior Myocardial Infarction

  • Katia Orvin,
  • Alon Shechter,
  • Doron Zahger,
  • Vitaly Shklovski,
  • Tal Ovdat,
  • Roy Beigel,
  • Ran Kornowski,
  • Alon Eisen

DOI
https://doi.org/10.3390/jcm10235580
Journal volume & issue
Vol. 10, no. 23
p. 5580

Abstract

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Patients who have previously had a myocardial infarction (MI) are considered a high-risk group with increased risk for cardiovascular (CV) events. During the last decade, the outcome of acute coronary syndrome (ACS) patients has improved due to advances in medical therapy and interventional techniques. We aimed to examine temporal trends and outcomes of patients with prior MI admitted due to ACS from the Acute Coronary Syndrome Israeli Survey (ACSIS). Included were 16,934 ACS patients, of whom 31.4% had prior MI. For temporal trend analysis, the cohort was divided into an early period (2000–2008) and late period (2010–2018). For patients with prior MI, patients in the late period had a higher rate of CV risk factors and were treated more frequently with revascularization and guidelines-directed medical therapy. Recurrent MI (6.7% vs. 12%, p p p p < 0.001) with an overall higher mortality rate in the STEMI group. Thus, despite significant improvement in outcome measures in the contemporary era, ACS patients with prior MI are still at increased risk for recurrent ischemic CV events and mortality.

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