Observed and relative survival and 5-year outcomes of patients discharged after acute myocardial infarction: the nationwide AMI-PL database

Abstract

Background: Long‑term follow‑up data from a large Polish acute myocardial infarction (AMI‑PL) database are still unavailable.

Aims: This study aimed to assess the 5‑year outcomes of patients discharged after hospitalization for AMI in Poland in relation to age.

Methods: The studywas based on the nationwide AMI‑PL registry including data on the management and long‑term outcomes of all patients admitted to hospitals with AMI (codes I21–I22 according to the International Classification of Diseases and Related Health Problems, 10th Revision [ICD ‑10]), derived from the database of the obligatory healthcare payer in Poland.The current analysis included all patients after AMI who were discharged alive between the years 2009 and 2010 (n = 134 602).

Results: The median age of the study patients was 66.8 years, 62.8% of them were male, and 57.1% had ST‑segment elevation myocardial infarction. Older patients, especially those at age ≥80 years, were less likely to receive invasive treatment during the index hospitalization and follow‑up. There were 37 437 deaths during the follow‑up, and the observed 5‑year survival ranged from 0.921 in women at the age below 55 years to 0.383 in men older than 80 years. Relative survival, however, ranged from 0.94 to 0.68 in these age‑sex groups. The mortality risk increased with age, was higher in men, in patients treated noninvasively, hospitalized for non–ST‑segment elevation myocardial infarction, and discharged from non‑cardiology wards. Patients were rehospitalized due to cardiovascular reasons in 63% of cases, heart failure in 17.9%, and AMI in 12.8%.

Conclusions: More than 1 in 4 patients discharged after hospitalization for AMI died within 5 years. Age strongly affects the treatment and long‑term outcomes of AMI patients. Our findings indicate the need for improvement in secondary prevention after AMI.