Kristin Marie Kvakkestad has studied short- and long-term survival among patients with myocardial infarction.
- The risk of long-term death is increased by 4-fold in very elderly STEMI patients.
- Women have better long-term survival than men following NSTEMI.
- Half of hospitalized patients were still alive eight years after out-of-hospital cardiac arrest.
Thesis: Survival after acute myocardial infarction, with emphasis on elderly, women and patients with out-of-hospital cardiac arrest. Results from the Oslo University Hospital Ulleval Myocardial Infarction Registry
Candidate: Kristin Marie Kvakkestad
Time: December 11, 2018 at 12:15
Place: University of Oslo, Domus Medica: Gamle festsal
Link to university website
Kvakkestad’s studies include approximately 10,000 men and women who were admitted to Oslo University Hospital with an acute myocardial infarction between 2005 and 2011. Almost half of them had a myocardial infarction with ST-elevation.
(1) 52 % of patients above 80 years of age were still alive three years after an acute STEMI. In-hospital mortality was 17 %, compared to only 4 % in younger patients. Mortality was lower in patients treated invasively.
The risk of in-hospital death was 2.6-fold increased compared to patients below 80, after adjustment for confounding factors and selection bias. The risk of long-term mortality was increased by 4.1.
(2) The prognosis is similar in women and men the first seven years after a STEMI, but women have better long-term prognosis following NSTEMI. More women than men died during follow-up, but that could be explained by the higher age in the female patients. Short-term mortality was similar in men and women after controlling for age.
(3) Among patients surviving the first 30 days, patients with cardiac arrest do not have significantly lower long-term survival than other patients with myocardial infarction. In total, 63 % of hospitalized patients survived the first 30 days after out-of-hospital cardiac arrest, and 49 % were still alive after eight years.
404 of the nearly 10,000 included patients with myocardial infarction had an out-of-hospital cardiac arrest.
(1) Kvakkestad, K. M., Abdelnoor, M., Claussen, P. A., Eritsland, J., Fossum, E., & Halvorsen, S. (2016). Long-term survival in octogenarians and older patients with ST-elevation myocardial infarction in the era of primary angioplasty: a prospective cohort study. European Heart Journal: Acute Cardiovascular Care, 5(3), 243-252.
(2) Kvakkestad, K. M., Fagerland, M. W., Eritsland, J., & Halvorsen, S. (2017). Gender differences in all-cause, cardiovascular and cancer mortality during long-term follow-up after acute myocardial infarction; a prospective cohort study. BMC cardiovascular disorders, 17(1), 75.
(3) Kvakkestad, K. M., Sandvik, L., Andersen, G. Ø., Sunde, K., & Halvorsen, S. (2018). Long-term survival in patients with acute myocardial infarction and out-of-hospital cardiac arrest: A prospective cohort study. Resuscitation, 122, 41-47.