What do patients receiving optimal medical therapy after a heart attack die from?

August 30, 2011, European Society of Cardiology

Because of improved management at the acute stage, the risk of dying in hospital after a heart attack has decreased by about 50% in the past 10 years. Likewise, the prescription of recommended medications when patients leave hospital, has resulted in improved survival and fewer recurrent heart attacks. One of the challenges is now to try and further decrease long-term mortality in patients who leave the hospital on "optimal" medical therapy (i.e. who are prescribed all the recommended medications).

The French registry of Acute ST-elevation and non-ST-elevation (FAST-MI) is a nationwide survey of patients hospitalised for in France at the end of 2005, during a one-month period. Patients included will be followed for a period of 10 years after the initial heart attack. At three years, fewer than 5% of the patients have been lost to follow-up.

Of a population of 3,670 patients included in the registry, 3,262 survived the initial hospitalization and had a complete prescription at discharge available. Among them, 1586 (49%) received optimal treatment (OMT).

Three-year survival was 88% in optimally treated patients, compared with 77.5% in those who did not receive all recommended medications. After taking into account the initial profile of the patients and the severity of the heart attack, there was an 18% reduction in the risk of dying in patients receiving optimal .

Analysis of the factors related with 3-year mortality in patients who received optimal treatment showed that the risk of death was related to older age (> 75 years), severity of the (larger infarction, more extensive disease of the coronary artery), associated conditions, such as diabetes mellitus, stroke, cancer or persistent smoking; in contrast, patients who had had a during the initial hospitalization had a markedly reduced risk of dying.

These findings suggest that there is still room for improvement in patients who receive the best possible medical treatment; of these patients, 12% still die during the 3 years that follow the initial .

A broader use of coronary angiography and myocardial revascularization during the initial hospitalisation is likely to have a favorable influence on long-term outcomes. In addition, additional efforts are needed and should concentrate on better management of larger infarctions to prevent and treat heart failure, and on associated conditions such as diabetes. Persistent smoking should also be fought relentlessly.

Explore further: Some heart attack rates declining and survival improving

Related Stories

Some heart attack rates declining and survival improving

January 12, 2011
Coronary syndromes vary in severity, ranging from unstable angina, non-ST segment elevation myocardial infarction (NSTEMI), to ST-segment elevation myocardial infarction (STEMI), the most severe diagnosis. Little data exist ...

HIV infection appears to increases the risk of heart attack

April 24, 2007
Researchers from Massachusetts General Hospital (MGH) have found that infection with HIV, the virus that causes AIDS, is also associated with increased risk of myocardial infarction or heart attack. While rates of several ...

Many patients with heart disease have poor knowledge of heart attack symptoms

May 26, 2008
Nearly half of patients with a history of heart disease have poor knowledge about the symptoms of a heart attack and do not perceive themselves to have an elevated cardiovascular risk, according to a report in the May 26 ...

Study shows emergency physicians have good first instincts in diagnosing heart attacks

July 24, 2008
A study out of Wake Forest University Baptist Medical Center demonstrates emergency room doctors are correctly identifying patients who are having a heart attack, even when laboratory tests haven't yet confirmed it.

Risk of repeat attacks in heart patients causes concern for doctors

August 28, 2008
An international study, led by the University of Edinburgh, raises concerns that some patients may not be receiving the optimum medical treatment and follow-up care because doctors are misjudging the risk of a further heart ...

Kidney disease linked to lower medication use after heart attack

July 9, 2008
Patients with kidney disease—especially end-stage renal disease (ESRD) requiring dialysis—are less likely to receive recommended medications after a heart attack, reports a study in the September 2008 Clinical Journal ...

Recommended for you

New treatment significantly reduces cardiovascular events when combined with statins

November 12, 2018
Statins are the most commonly used treatment for cardiovascular disease. Despite reducing certain risk factors, if triglyceride levels remain high with use of statins, there is still a significant risk for heart attack, stroke ...

Kawasaki disease: One disease, multiple triggers

November 12, 2018
Researchers at University of California San Diego School of Medicine, Scripps Institution of Oceanography, and international collaborators have evidence that Kawasaki Disease (KD) does not have a single cause. By studying ...

Study: How vitamin D and fish oil affect risk of heart attack, stroke and cancer

November 12, 2018
For years, it's remained an open question: What effects do dietary supplements such as high doses of vitamin D or omega-3 fatty acids derived from fish oil have on the risk of diseases such as heart attack, stroke and cancer? ...

Diabetes drug might also ease heart failure risks

November 12, 2018
(HealthDay)—The diabetes drug Farxiga might do double-duty for patients, helping to ward off another killer, heart failure, new research shows.

Updated cholesterol guidelines offer more personalized risk assessment, additional treatment options

November 12, 2018
More personalized risk assessments and new cholesterol-lowering drug options for people at the highest risk for cardiovascular disease (CVD) are among the key recommendations in the 2018 cholesterol guidelines from the American ...

Heart meeting features fish oil, vitamin D, cholesterol news

November 11, 2018
Fish oil, vitamin D, novel drugs, new cholesterol guidelines: News from an American Heart Association conference over the weekend reveals a lot about what works and what does not for preventing heart attacks and other problems.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.