De Luca Leonardo, Colivicchi Furio, Gabrielli Domenico, Lucci Donata, Grippo Gabriele, Piemonte Francesco, Villari Bruno, Di Lenarda Andrea, Oliva Fabrizio, Gulizia Michele Massimo
Department of Cardiosciences, Division of Cardiology, A.O. San Camillo-Forlanini, Roma, Italy.
Division of Cardiology, S. Filippo Neri Hospital, Roma, Italy.
J Interv Cardiol. 2022 Mar 18;2022:4593325. doi: 10.1155/2022/4593325. eCollection 2022.
It is unknown whether patients who survived two or multiple episodes of myocardial infarction (MI) present different clinical characteristics and management than patients at their first MI.
The EYESHOT post-MI was a prospective, observational, nationwide study aimed to evaluate the management of patients presenting to cardiologists 1 to 3 years from the last MI event. In 3 months of enrolment, 165 Italian cardiology centers included 1633 consecutive post-MI patients. In the present analysis, we stratified the study cohort according to the number of prior MI episodes (i.e., 1, 2 or ≥3).
Among the 1618 patients enrolled with complete data on MI history, 1335 (82.5%) were at their first MI episode, 209 (12.9%) had a history of 2 MIs, and the remaining 74 (4.6%) had ≥ 3 prior MIs. Patients with a history of multiple MIs were increasingly older and presented a significantly higher rate of risk factors compared to those at their first MI. During the year prior to enrolment, patients with 2 or ≥3 MI episodes more frequently underwent coronary angiography compared to the other group ( < 0.0001). In addition, several lifesaving and antianginal drugs were more frequently prescribed in patients presenting with a history of multiple MIs compared to those at their first MI.
Our data suggest that patients with multiple MIs managed by cardiologists in routine clinical practice present an incremental clinical risk, more frequently undergo coronary angiography, and are more intensively managed with pharmacological therapies compared to patients at their first MI episode.
与首次发生心肌梗死（MI）的患者相比，经历过两次或多次MI发作的幸存者是否具有不同的临床特征和治疗方式尚不清楚。
EYESHOT心肌梗死后研究是一项前瞻性、观察性的全国性研究，旨在评估自上次MI事件起1至3年就诊于心脏病专家的患者的治疗情况。在入组的3个月内，165个意大利心脏病中心纳入了1633例连续的心肌梗死后患者。在本分析中，我们根据既往MI发作次数（即1次、2次或≥3次）对研究队列进行分层。
在1618例有完整MI病史数据的入组患者中，1335例（82.5%）为首次MI发作，209例（12.9%）有2次MI病史，其余74例（4.6%）有≥3次既往MI发作。与首次MI发作的患者相比，有多次MI病史的患者年龄越来越大，危险因素发生率显著更高。在入组前一年，有2次或≥3次MI发作的患者比其他组更频繁地接受冠状动脉造影（<0.0001）。此外，与首次MI发作的患者相比，有多次MI病史的患者更频繁地使用几种救命和抗心绞痛药物。
我们的数据表明，在常规临床实践中由心脏病专家管理的多次MI患者与首次MI发作的患者相比，临床风险增加，更频繁地接受冠状动脉造影，并且在药物治疗方面管理更积极。
