Background
Methods
Patient population: the AMI code program
In-hospital data collection
Clinical follow-up
Statistical analysis
Results
Patient population
Patient characteristics | Total (n = 423) | Men (n = 319) | Women (n = 104) |
p-value |
Age (years) | 63 ± 13.1 | 60.9 ± 12.7 | 69.2 ± 12.4 | <0.001 |
Current smokers | 201 (47.9%) | 173 (54.4%) | 28 (27.5%) | <0.001 |
Former smokers (>1 year) | 100 (23.8%) | 92 (28.9%) | 8 (7.8%) | <0.001 |
Hypertension | 235 (55.5%) | 165 (51.7%) | 70 (67.3%) | <0.001 |
Dyslipidemia | 0.062 | |||
Drug treatment No drug treatment | 134 (32.5%) 73 (17.7%) | 94 (30.3%) 62 (20%) | 40 (39.2%) 11 (10.8%) | |
Diabetes mellitus | 112 (26%) | 76 (24%) | 36 (35%) | 0.107 |
Family historya
| 39 (11%) | 29 (10.5%) | 10 (12.3%) | 0.800 |
Previous ischemic heart disease | 44 (10.4%) | 35 (11%) | 9 (8.7%) | 0.626 |
Chronic kidney disease | 14 (3.4%) | 7 (2.3%) | 7 (6.9%) | 0.052 |
Anemia | 33 (8.2%) | 19 (6.3%) | 14 (14.1%) | 0.023 |
AMI data | ||||
Systolic blood pressure at admission (mmHg) | 130 [114–150] | 130 [112–148] | 140 [120–164] | 0.003 |
Infarct location | 0.713 | |||
Anterior | 151 (35.7%) | 112 (35.1%) | 39 (37.5%) | |
Inferior | 231 (54.6%) | 178 (55.8%) | 53 (51%) | |
Killip class | 0.137 | |||
I | 341 (83.2%) | 264 (84.9%) | 77 (77.8%) | |
II | 35 (8.1%) | 22 (7.1%) | 11 (11.1%) | |
III | 16 (3.9%) | 9 (2.9%) | 7 (7.1%) | |
IV | 21 (4.9%) | 16 (5.1%) | 4 (4.1%) | |
LVEF | 52.1 ± 12 | 52,5 ± 12 | 51 ± 12 | 0.283 |
Blood test at admission | Total (n = 423) | Men (n = 319) | Women (n = 104) |
p-value |
Hb (gr/dL) | 14 ± 1.8 | 14.4 ± 1.7 | 12.9 ± 1.7 | <0.001 |
GFR (mL/min/m2) | 60 [60–60] | 60 [60–60] | 60 [60–60] | 0.006 |
Basal glucose (mg/dL) | 111 [98–136] | 110 [98–133] | 114 [97–148] | 0.423 |
HbA1c (%) (in DM) | 7.25 [6.60–8.53] | 7.30 [6.60–8.53] | 7.10 [6.60–8.08] | 0.643 |
Total Cholesterol (mg/dL) | 183 [150–214] | 182 [151–212] | 188 [150–219] | 0.425 |
LDL-Cholesterol (mg/dL) | 112 [84–139] | 112 [85–138] | 112 [82–142] | 0.842 |
HDL-Cholesterol (mg/dL) | 44 [37–53] | 42 [36–50] | 49 [41–60] | <0.001 |
Triglycerides (mg/dL) | 120 [88–168] | 124 [91–173] | 112 [80–159] | 0.061 |
Cardiovascular risk factors at 1-year follow-up
Global | Men | Women |
p-value | |
---|---|---|---|---|
Systolic blood pressure (mmHg) | 126 [115–137] | 125 [115–136] | 130 [116–137] | 0.355 |
Total Cholesterol (mg/dL) | 148 [129–175] | 146 [127–167] | 163 [140–191] | <0.001 |
LDL-Cholesterol (mg/dL) | 80 [65–99] | 77 [65–93] | 90 [67–112] | 0.005 |
HDL-Cholesterol (mg/dL) | 44 [38–52] | 44 [36–50] | 49 [42–57] | <0.001 |
Triglycerides (mg/dL) | 105 [81–150] | 102 [81–146] | 116 [82–158] | 0.245 |
HbA1c (%) (in DM) | 7.75 ± 1.84 | 7.78 ± 1.91 | 7.68 ± 1.71 | 0.824 |
Impact of clinical variables and risk factor control on long-term cardiovascular outcome
Patient characteristics | Event (n = 61) | No event (n = 362) |
p-value |
Age (years) | 67 ± 15 | 63 ± 13 | 0.047 |
Current smokers | 25 (%) | 168 (46%) | 0.295 |
Hypertension | 44 (72.1%) | 186 (51.4%) | 0.016 |
Dyslipidemia | 32 (52.5%) | 170 (47%) | 0.356 |
Diabetes mellitus | 16 (26.2%) | 72 (19.9%) | 0.273 |
Family history* | 6 (9.8%) | 31 (8.6%) | 0.946 |
Chronic kidney disease | 3 (4.9%) | 11 (3%) | 0.448 |
Anemia | 10 (16.4%) | 23 (6.4%) | 0.018 |
AMI dataa
| Event (n = 61) | No event (n = 362) |
p-value |
Infarct location | 0.08 | ||
Anterior | 29 (47.5%) | 116 (32%) | |
Inferior | 28 (45.9%) | 196 (54%) | |
Killip class | <0.001 | ||
I | 37 (60.6%) | 300 (82.9%) | |
II | 9 (14.8%) | 30 (8.3%) | |
III | 9 (14.8%) | 13 (3.6%) | |
IV | 6 (9.8%) | 19 (5.2%) | |
LVEFa
| 46.3 ± 12.6 | 53.1 ± 11.3 | <0.001 |
Mortality | HR [CI 95%] |
p-value |
Age | 1.02 [0.98–1.06] | 0.24 |
Women | 0.89 [0.34–2.30] | 0.81 |
Hypertension | 3.73 [1.18–11.82] | 0.03 |
Anemia | 3.82 [1.47–9.92] | 0.03 |
Killip class III-IV | 5.40 [2.05–14.24] | <0.001 |
LVEF > 45% | 0.22 [0.09–0.55] | <0.001 |
Cardiovascular readmission | HR [CI 95%] |
p-value |
Age | 1.01 [0.98–1.04] | 0.42 |
Women | 1.34 [0.70–2.59] | 0.38 |
Hypertension | 2.72 [1.26–5.87] | 0.01 |
Anemia | 1.39 [0.59–3.29] | 0.45 |
Killip class III-IV | 3.56 [1.49–8.49] | <0.001 |
LVEF > 45% | 0.37 [0.20–0.69] | <0.001 |
HR [CI 95%] |
p-value | ||
---|---|---|---|
Total cholesterol | Not assessed Not controlled | 1.47 [0.74–2.93] 0.18 [0.02–1.36] | 0.28 0.10 |
LDL-cholesterol | Not assessed Not controlled | 2.57 [1.26–5.24] 0.89 [0.44–1.81] | 0.01 0.76 |
HDL-cholesterol | Not assessed Not controlled | 2.88 [1.54–5.39] 1.26 [0.61–2.61] | <0.001 0.53 |
Triglycerides | Not assessed Not controlled | 1.80 [0.90–3.59] 1.12 [0.56–2.21] | 0.09 0.75 |
HbA1c | Not assessed Not controlled | 0.80 [0.19–3.31] 0.48 [0.90–2.66] | 0.76 0.40 |
Blood pressure | Not assessed Not controlled | 1.04 [0.51–2.12] 0.58 [0.25–1.32] | 0.92 0.19 |
Smoking | Not assessed Not controlled | 0.73 [0.38–1.40] 2.05 [0.83–5.05] | 0.35 0.12 |