Department of Epidemiology, Medical Faculty, University of Augsburg, Augsburg, Germany.
Department of Cardiology, Respiratory Medicine and Intensive Care, University Hospital Augsburg, Augsburg, Germany.
Ann Med. 2024 Dec;56(1):2424449. doi: 10.1080/07853890.2024.2424449. Epub 2024 Nov 18.
To investigate the most common causes of death and trends in cause-specific long-term mortality in patients hospitalized for acute myocardial infarction (AMI).
This analysis was based on 10,718 patients, aged 25-74 years, recorded by the population-based Myocardial Infarction Registry Augsburg between 2000 and 2017. All hospitalized cases of AMI occurring in the study region during this period were included. If a patient died during follow-up (median: 6.6 years, IQR: 2.8-11.2) the death certificate was obtained and coded using the ICD-10 to determine the main cause of death. Cause-specific mortality was calculated for three 6-year periods. Multivariable adjusted Cox regression models stratified by time interval were calculated.
The most common cause of death was cardiovascular disease (CVD), more precisely ischemic-heart disease (IHD), followed by cancer. The proportions of CVD deaths and IHD deaths were stable over time. An increasing trend was observed in cancer mortality in post-AMI patients. In male patients, the hazard ratio for cancer mortality was 44.4% higher in 2012-2017 compared to 2000-2005, in female patients, it was more than twice as high in 2006-2012 compared to 2000-2005.
This study revealed consistent CVD and IHD long-term mortality and increasing trends in long-term cancer mortality in patients post-AMI. Thus, post-AMI patients should emphasize tertiary prevention of CVD by minimizing risk factors. Furthermore, patients should regularly undergo cancer screening programs. The reasons for the unfavorable development in terms of increasing cancer mortality should be investigated in further studies.
研究因急性心肌梗死（AMI）住院患者的主要死亡原因和特定病因长期死亡率的趋势。
本分析基于 2000 年至 2017 年期间人群为基础的奥格斯堡心肌梗死登记处（Myocardial Infarction Registry Augsburg）记录的 10718 名年龄在 25-74 岁的患者。研究期间，该研究区域内所有因 AMI 住院的病例均包括在内。如果患者在随访期间死亡（中位数：6.6 年，IQR：2.8-11.2），则获得死亡证明并使用 ICD-10 进行编码，以确定主要死亡原因。计算了三个 6 年期间的特定病因死亡率。计算了按时间间隔分层的多变量调整 Cox 回归模型。
最常见的死亡原因是心血管疾病（CVD），更确切地说是缺血性心脏病（IHD），其次是癌症。CVD 死亡和 IHD 死亡的比例随时间保持稳定。AMI 后患者的癌症死亡率呈上升趋势。在男性患者中，2012-2017 年与 2000-2005 年相比，癌症死亡率的危险比（HR）高 44.4%，在女性患者中，2006-2012 年与 2000-2005 年相比，癌症死亡率的 HR 高 2 倍以上。
这项研究揭示了 AMI 后患者的 CVD 和 IHD 长期死亡率一致，以及长期癌症死亡率呈上升趋势。因此，AMI 后患者应通过将危险因素最小化来强调 CVD 的三级预防。此外，患者应定期接受癌症筛查计划。应在进一步的研究中调查癌症死亡率增加的不利发展的原因。
