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Long-term cardiovascular mortality after procedure-related or spontaneous myocardial infarction in patients with non-ST-segment elevation acute coronary syndrome: a collaborative analysis of individual patient data from the FRISC II, ICTUS, and RITA-3 trials (FIR).
Circulation. 2012 Jan 31; 125(4):568-76.Circ

Abstract

BACKGROUND

The present study was designed to investigate the long-term prognostic impact of procedure-related and spontaneous myocardial infarction (MI) on cardiovascular mortality in patients with non-ST-elevation acute coronary syndrome.

METHODS AND RESULTS

Five-year follow-up after procedure-related or spontaneous MI was investigated in the individual patient pooled data set of the FRISC-II (Fast Revascularization During Instability in Coronary Artery Disease), ICTUS (Invasive Versus Conservative Treatment in Unstable Coronary Syndromes), and RITA-3 (Randomized Intervention Trial of Unstable Angina 3) non-ST-elevation acute coronary syndrome trials. The principal outcome was cardiovascular death up to 5 years of follow-up. Cumulative event rates were estimated by the Kaplan-Meier method; hazard ratios were calculated with time-dependent Cox proportional hazards models. Adjustments were made for the variables associated with long-term outcomes. Among the 5467 patients, 212 experienced a procedure-related MI within 6 months after enrollment. A spontaneous MI occurred in 236 patients within 6 months. The cumulative cardiovascular death rate was 5.2% in patients who had a procedure-related MI, comparable to that for patients without a procedure-related MI (hazard ratio 0.66; 95% confidence interval, 0.36-1.20, P=0.17). In patients who had a spontaneous MI within 6 months, the cumulative cardiovascular death rate was 22.2%, higher than for patients without a spontaneous MI (hazard ratio 4.52; 95% confidence interval, 3.37-6.06, P<0.001). These hazard ratios did not change materially after risk adjustments.

CONCLUSIONS

Five-year follow-up of patients with non-ST-elevation acute coronary syndrome from the 3 trials showed no association between a procedure-related MI and long-term cardiovascular mortality. In contrast, there was a substantial increase in long-term mortality after a spontaneous MI.

Authors+Show Affiliations

Department of Cardiology, Cardiac Catheterization Laboratory B2-213, Academic Medical Center-University of Amsterdam, Meibergdreef 9, Amsterdam, Netherlands. p.damman@amc.uva.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22199015

Citation

Damman, Peter, et al. "Long-term Cardiovascular Mortality After Procedure-related or Spontaneous Myocardial Infarction in Patients With non-ST-segment Elevation Acute Coronary Syndrome: a Collaborative Analysis of Individual Patient Data From the FRISC II, ICTUS, and RITA-3 Trials (FIR)." Circulation, vol. 125, no. 4, 2012, pp. 568-76.
Damman P, Wallentin L, Fox KA, et al. Long-term cardiovascular mortality after procedure-related or spontaneous myocardial infarction in patients with non-ST-segment elevation acute coronary syndrome: a collaborative analysis of individual patient data from the FRISC II, ICTUS, and RITA-3 trials (FIR). Circulation. 2012;125(4):568-76.
Damman, P., Wallentin, L., Fox, K. A., Windhausen, F., Hirsch, A., Clayton, T., Pocock, S. J., Lagerqvist, B., Tijssen, J. G., & de Winter, R. J. (2012). Long-term cardiovascular mortality after procedure-related or spontaneous myocardial infarction in patients with non-ST-segment elevation acute coronary syndrome: a collaborative analysis of individual patient data from the FRISC II, ICTUS, and RITA-3 trials (FIR). Circulation, 125(4), 568-76. https://doi.org/10.1161/CIRCULATIONAHA.111.061663
Damman P, et al. Long-term Cardiovascular Mortality After Procedure-related or Spontaneous Myocardial Infarction in Patients With non-ST-segment Elevation Acute Coronary Syndrome: a Collaborative Analysis of Individual Patient Data From the FRISC II, ICTUS, and RITA-3 Trials (FIR). Circulation. 2012 Jan 31;125(4):568-76. PubMed PMID: 22199015.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term cardiovascular mortality after procedure-related or spontaneous myocardial infarction in patients with non-ST-segment elevation acute coronary syndrome: a collaborative analysis of individual patient data from the FRISC II, ICTUS, and RITA-3 trials (FIR). AU - Damman,Peter, AU - Wallentin,Lars, AU - Fox,Keith A A, AU - Windhausen,Fons, AU - Hirsch,Alexander, AU - Clayton,Tim, AU - Pocock,Stuart J, AU - Lagerqvist,Bo, AU - Tijssen,Jan G P, AU - de Winter,Robbert J, Y1 - 2011/12/23/ PY - 2011/12/27/entrez PY - 2011/12/27/pubmed PY - 2012/3/21/medline SP - 568 EP - 76 JF - Circulation JO - Circulation VL - 125 IS - 4 N2 - BACKGROUND: The present study was designed to investigate the long-term prognostic impact of procedure-related and spontaneous myocardial infarction (MI) on cardiovascular mortality in patients with non-ST-elevation acute coronary syndrome. METHODS AND RESULTS: Five-year follow-up after procedure-related or spontaneous MI was investigated in the individual patient pooled data set of the FRISC-II (Fast Revascularization During Instability in Coronary Artery Disease), ICTUS (Invasive Versus Conservative Treatment in Unstable Coronary Syndromes), and RITA-3 (Randomized Intervention Trial of Unstable Angina 3) non-ST-elevation acute coronary syndrome trials. The principal outcome was cardiovascular death up to 5 years of follow-up. Cumulative event rates were estimated by the Kaplan-Meier method; hazard ratios were calculated with time-dependent Cox proportional hazards models. Adjustments were made for the variables associated with long-term outcomes. Among the 5467 patients, 212 experienced a procedure-related MI within 6 months after enrollment. A spontaneous MI occurred in 236 patients within 6 months. The cumulative cardiovascular death rate was 5.2% in patients who had a procedure-related MI, comparable to that for patients without a procedure-related MI (hazard ratio 0.66; 95% confidence interval, 0.36-1.20, P=0.17). In patients who had a spontaneous MI within 6 months, the cumulative cardiovascular death rate was 22.2%, higher than for patients without a spontaneous MI (hazard ratio 4.52; 95% confidence interval, 3.37-6.06, P<0.001). These hazard ratios did not change materially after risk adjustments. CONCLUSIONS: Five-year follow-up of patients with non-ST-elevation acute coronary syndrome from the 3 trials showed no association between a procedure-related MI and long-term cardiovascular mortality. In contrast, there was a substantial increase in long-term mortality after a spontaneous MI. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/22199015/Long_term_cardiovascular_mortality_after_procedure_related_or_spontaneous_myocardial_infarction_in_patients_with_non_ST_segment_elevation_acute_coronary_syndrome:_a_collaborative_analysis_of_individual_patient_data_from_the_FRISC_II_ICTUS_and_RITA_3_trials__FIR__ L2 - https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.111.061663?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -