Huynh T, et al. - This research incorporated a characterization of the 10-year incidence, types, and predictors of recurrent ischemic cardiovascular events (RICE) following myocardial infarction with ST-segment elevation (STEMI). A persistent high, long-term risk of RICE was disclosed among the survivors of STEMI, regardless of the high rate of reperfusion therapy and in-hospital percutaneous coronary intervention (PCI). Individuals who were susceptible to RICE included patients with prior CV event, in-hospital heart failure and high Thrombolysis in Myocardial Infarction (TIMI) score.

Methods

• Data was extracted from the 10-year follow-up of STEMI survivors at 17 Quebec hospitals in Canada (the AMI-QUEBEC Study) in 2003.
• The eligible candidates included 858 patients; mean age of 60 years, among whom 73% were males.
• Maximum patients received reperfusion therapy, wherein 53.3% and 39.2% received primary PCI and fibrinolytic therapy, respectively.
• In-hospital PCI (elective, rescue and primary) was carried out in 75% of patients.
• Results exhibited that 42% of patients suffered a RICE with most RICEs (88%) caused by recurrent cardiac ischemia at 10-year.

Results

• Experts illustrated that the risk of RICE was highest during the first year (23.5 per person-year).
• Findings disclosed that the all-cause mortality was 19.3% with one-third of deaths being RICE-related at 10-year.
• Nearly a two-fold increase was noted in the risk of RICE due to prior CV event, heart failure during the index STEMI hospitalization, discharge prescription of calcium-blocker.
• It was deduced that each point increase in Thrombolysis in Myocardial Infarction (TIMI) score augmented the risk of RICE by 6%.
• In contrast, the risk of RICE was reduced by 23% through the discharge prescription of dual anti-platelets.