More than half of those above 80 are still alive three years after STEMI

Kristin Marie Kvakkestad has studied short- and long-term survival among patients with myocardial infarction.


MAIN RESULTS:

  1. The risk of long-term death is increased by 4-fold in very elderly STEMI patients.
  2. Women have better long-term survival than men following NSTEMI.
  3. Half of hospitalized patients were still alive eight years after out-of-hospital cardiac arrest.

THESIS DEFENCE:

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


SUMMARY:

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.


REFERENCES:

(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 studyEuropean Heart Journal: Acute Cardiovascular Care5(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 studyBMC cardiovascular disorders17(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 studyResuscitation122, 41-47.