Surprising trends in cause of long-term death after percutaneous coronary intervention

February 10, 2014

More people who have known coronary heart disease die from other causes—such as cancer, and lung and neurological diseases—than heart disease, compared with 20 years ago, according to a Mayo Clinic study published online today in Circulation, an American Heart Association journal.

The researchers evaluated the trends in cause-specific, long-term mortality from 1991 to 2008 in patients at Mayo Clinic in Rochester who underwent (PCI), a procedure used to open . They broke the study population into three eras: 1991 to 1996, 1997 to 2002, and 2003 to 2008. Cardiac deaths predominated in the first era and were about equal with non- in the middle era. In the final era—the modern-era (2003 to 2008)—non-cardiac deaths dominated.

Approximately 20,000 PCI patients were studied. Of those, nearly 7,000 patients died within the study time frame. Among that group, only 37 percent of deaths in the modern-era (2003-2008) were cardiac-related.

"We found that patients with established undergoing angioplasty and stenting in the modern era have about a 1 in 3 chance of dying from their heart disease, and a 2 in 3 chance of dying from non-cardiac diseases in the long term," says Rajiv Gulati, M.D., Ph.D., senior author and Mayo Clinic interventional cardiologist.

The results surprised the authors, Dr. Gulati says. First, patients undergoing angioplasty in the modern era have gotten older, with more complex coronary disease and more risk factors compared with years ago. So, the authors were expecting their cardiac death rates to have increased. "In addition, in randomized clinical trials of PCI, deaths from cardiac disease still predominate," he says. The authors believe the sharp decline in long-term cardiac deaths in these patients may result from improved cardiac therapies. For example, more patients today with established heart disease take medications to lower cholesterol, prevent heart failure, and decrease blood pressure, and technologies used in catheterization laboratories—where PCI is performed—have improved, Dr. Gulati says.

Of the cardiac-specific deaths, deaths from heart attack and sudden heart rhythm disturbances declined steeply, but there was no decline in deaths from heart failure.

"These results show that we have an opportunity to focus on the non-cardiac diseases in these patients—to treat the patient holistically," Dr. Gulati says. "But it also gives us the opportunity to identify and target those patients who are at risk of dying from heart disease."

Explore further: Heart disease patients with positive attitudes likely to exercise, live longer

Related Stories

Heart disease patients with positive attitudes likely to exercise, live longer

September 10, 2013
Heart disease patients with positive attitudes are more likely to exercise and live longer, according to new research in the American Heart Association journal Circulation: Cardiovascular Quality and Outcomes.

Psychological interventions halve deaths and CV events in heart disease patients

October 12, 2013
Psychological interventions halve deaths and cardiovascular events in heart disease patients, according to research from Athens, Greece, presented at the Acute Cardiac Care Congress 2013.

Unfolded protein response contributes to sudden death in heart failure

December 2, 2013
A researcher at the Cardiovascular Institute (CVI) at Rhode Island, The Miriam and Newport hospitals has found a link to human heart failure that if blocked, may reduce the risk of sudden cardiac death. The paper, written ...

Heart disease risk appears associated with breast cancer radiation

October 28, 2013
Among patients with early stages of breast cancer, those whose hearts were more directly irradiated with radiation treatments on the left side in a facing-up position had higher risk of heart disease, according to research ...

Chest pain prior to a heart attack can protect the heart

February 5, 2013
Patients who experience chest pain in the 24 hours preceding a heart attack, also called preinfarction angina, have smaller heart attacks and improved cardiac function in the contemporary cardiac stenting era, researchers ...

Recommended for you

How Gata4 helps mend a broken heart

August 15, 2017
During a heart attack, blood stops flowing into the heart; starved for oxygen, part of the heart muscle dies. The heart muscle does not regenerate; instead it replaces dead tissue with scars made of cells called fibroblasts ...

Injectable tissue patch could help repair damaged organs

August 14, 2017
A team of U of T Engineering researchers is mending broken hearts with an expanding tissue bandage a little smaller than a postage stamp.

'Fat but fit' are at increased risk of heart disease

August 14, 2017
Carrying extra weight could raise your risk of heart attack by more than a quarter, even if you are otherwise healthy.

Air pollution linked to cardiovascular disease; air purifiers may lessen impact

August 14, 2017
Exposure to high levels of air pollution increased stress hormone levels and negative metabolic changes in otherwise healthy, young adults in a recent study conducted in China. Air purifiers appeared to lessen the negative ...

Study hints at experimental therapy for heart fibrosis

August 14, 2017
Researchers report encouraging preclinical results as they pursue elusive therapeutic strategies to repair scarred and poorly functioning heart tissues after cardiac injury—describing an experimental molecular treatment ...

Scientists identify mutations in venous valve disease

August 14, 2017
A team of scientists has discovered that mutations in the genes FOXC2 and GJC2 are associated with defects in venous valves, flaps within veins that help maintain proper blood flow.

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.