ArticleBMJ open2017
Survival prospects after acute myocardial infarction in the UK: a matched cohort study 1987-2011.
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Risk prediction in people with acute myocardial infarction in England: a cohort study using data from 1521 general practices.BMJ open · 2025Article
- Contemporary secondary prevention in survivors of ST-elevation myocardial infarction with and without chronic kidney disease: a retrospective analysis.Clinical kidney journal · 2023Article
- Sociodemographic and clinical variables as determinants of mortality and survival in patients with acute ST-elevation myocardial infarction in the Eastern Amazon.Journal of public health research · 2023Article
- Do statins reduce mortality in older people? Findings from a longitudinal study using primary care records.Family medicine and community health · 2021Article
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3 authors.
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Abstract
objectivesEstimate survival after acute myocardial infarction (AMI) in the general population aged 60 and over and the effect of recommended treatments.
designCohort study in the UK with routinely collected data between January 1987 and March 2011.
setting310 general practices that contributed to The Health Improvement Network (THIN) database.
participants4 cohorts who reached the age of 60, 65, 70, or 75 years between 1987 and 2011 included 16 744, 43 528, 73 728, and 76 392 participants, respectively. Participants with a history of AMI were matched on sex, year of birth, and general practice to 3 controls each. OUTCOME MEASURES: The hazard of all-cause mortality associated with AMI was calculated by a multilevel Cox's proportional hazards regression, adjusted for sex, year of birth, socioeconomic status, angina, heart failure, other cardiovascular conditions, chronic kidney disease, diabetes, hypertension, hypercholesterolaemia, alcohol consumption, body mass index, smoking status, coronary revascularisation, prescription of β-blockers, ACE inhibitors, calcium-channel blockers, aspirin, or statins, and general practice.
resultsCompared with no history of AMI by age 60, 65, 70, or 75, having had 1 AMI was associated with an adjusted hazard of mortality of 1.80 (95% CI 1.60 to 2.02), 1.71 (1.59 to 1.84), 1.50 (1.42 to 1.59), or 1.45 (1.38 to 1.53), respectively, and having had multiple AMIs with a hazard of 1.92 (1.60 to 2.29), 1.87 (1.68 to 2.07), 1.66 (1.53 to 1.80), or 1.63 (1.51 to 1.76), respectively. Survival was better after statins (HR range across the 4 cohorts 0.74-0.81), β-blockers (0.79-0.85), or coronary revascularisation (in first 5 years) (0.72-0.80); unchanged after calcium-channel blockers (1.00-1.07); and worse after aspirin (1.05-1.10) or ACE inhibitors (1.10-1.25).
conclusionsThe hazard of death after AMI is less than reported by previous studies, and standard treatments of aspirin or ACE inhibitors prescription may be of little benefit or even cause harm.
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