Two-year outcomes among stable high-risk patients following acute MI. Insights from a global registry in 25 countries.
Identifieur interne : 000263 ( Main/Corpus ); précédent : 000262; suivant : 000264Two-year outcomes among stable high-risk patients following acute MI. Insights from a global registry in 25 countries.
Auteurs : David Brieger ; Stuart J. Pocock ; Stefan Blankenberg ; Ji Yan Chen ; Mauricio G. Cohen ; Christopher B. Granger ; Richard Grieve ; Jose C. Nicolau ; Tabassome Simon ; Dirk Westermann ; Satoshi Yasuda ; John Gregson ; Kirsten L. Rennie ; Katarina Hedman ; Karolina Andersson Sundell ; Shaun G. GoodmanSource :
- International journal of cardiology [ 1874-1754 ] ; 2020.
Abstract
BACKGROUND
Evidence is lacking on long-term outcomes in unselected patients surviving the first year following myocardial infarction (MI).
METHODS AND RESULTS
The TIGRIS (long-Term rIsk, clinical manaGement and healthcare Resource utilization of stable coronary artery dISease in post-myocardial infarction patients) prospective registry enrolled 9176 eligible patients aged ≥50 years, 1-3 years post-MI, from 25 countries. All had ≥1 risk factor: age ≥ 65 years, diabetes mellitus, second prior MI, multivessel coronary artery disease, chronic kidney disease (CKD). Primary outcome was a composite of MI, unstable angina with urgent revascularization, stroke, or all-cause death at 2-year follow-up. Bleeding requiring hospitalization was also recorded. 9027 patients (98.4%) provided follow-up data: the primary outcome occurred in 621 (7.0%), all-cause mortality in 295 (3.3%), and bleeding in 109 (1.2%) patients. Events accrued linearly over time. In multivariable analyses, qualifying risk factors were associated with increased risk of primary outcome (incidence rate ratio [RR] per 100 patient-years [95% confidence interval]): CKD 2.06 (1.66, 2.55), second prior MI 1.71 (1.38, 2.10), diabetes mellitus 1.63 (1.39, 1.92), age ≥ 65 years 1.53 (1.28, 1.83), and multivessel disease 1.24 (1.05, 1.48). Risk of bleeding events was greater in older patients (vs <65 years) 65-74 years 2.68 (1.53, 4.70), ≥75 years 4.62 (2.57, 8.28), and those with CKD 1.99 (1.18, 3.35).
CONCLUSION
In stable patients recruited 1-3 years post-MI, recurrent cardiovascular and bleeding events accrued linearly over 2 years. Factors independently predictive of ischemic and bleeding events were identified, providing a context for deciding on treatment options.
DOI: 10.1016/j.ijcard.2020.01.070
PubMed: 32057476
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pubmed:32057476Le document en format XML
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<author><name sortKey="Rennie, Kirsten L" sort="Rennie, Kirsten L" uniqKey="Rennie K" first="Kirsten L" last="Rennie">Kirsten L. Rennie</name>
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<author><name sortKey="Hedman, Katarina" sort="Hedman, Katarina" uniqKey="Hedman K" first="Katarina" last="Hedman">Katarina Hedman</name>
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<author><name sortKey="Sundell, Karolina Andersson" sort="Sundell, Karolina Andersson" uniqKey="Sundell K" first="Karolina Andersson" last="Sundell">Karolina Andersson Sundell</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">Two-year outcomes among stable high-risk patients following acute MI. Insights from a global registry in 25 countries.</title>
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<author><name sortKey="Blankenberg, Stefan" sort="Blankenberg, Stefan" uniqKey="Blankenberg S" first="Stefan" last="Blankenberg">Stefan Blankenberg</name>
<affiliation><nlm:affiliation>Department of General and Interventional, University Heart Center Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner site Hamburg/Lübeck/Kiel, Hamburg, Germany.</nlm:affiliation>
</affiliation>
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<author><name sortKey="Chen, Ji Yan" sort="Chen, Ji Yan" uniqKey="Chen J" first="Ji Yan" last="Chen">Ji Yan Chen</name>
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<author><name sortKey="Cohen, Mauricio G" sort="Cohen, Mauricio G" uniqKey="Cohen M" first="Mauricio G" last="Cohen">Mauricio G. Cohen</name>
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<author><name sortKey="Granger, Christopher B" sort="Granger, Christopher B" uniqKey="Granger C" first="Christopher B" last="Granger">Christopher B. Granger</name>
<affiliation><nlm:affiliation>Duke Clinical Research Institute, Duke University Medical Center, Durham, USA.</nlm:affiliation>
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<author><name sortKey="Grieve, Richard" sort="Grieve, Richard" uniqKey="Grieve R" first="Richard" last="Grieve">Richard Grieve</name>
<affiliation><nlm:affiliation>London School of Hygiene and Tropical Medicine, London, United Kingdom.</nlm:affiliation>
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<author><name sortKey="Nicolau, Jose C" sort="Nicolau, Jose C" uniqKey="Nicolau J" first="Jose C" last="Nicolau">Jose C. Nicolau</name>
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<author><name sortKey="Simon, Tabassome" sort="Simon, Tabassome" uniqKey="Simon T" first="Tabassome" last="Simon">Tabassome Simon</name>
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</affiliation>
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<author><name sortKey="Westermann, Dirk" sort="Westermann, Dirk" uniqKey="Westermann D" first="Dirk" last="Westermann">Dirk Westermann</name>
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<author><name sortKey="Yasuda, Satoshi" sort="Yasuda, Satoshi" uniqKey="Yasuda S" first="Satoshi" last="Yasuda">Satoshi Yasuda</name>
<affiliation><nlm:affiliation>National Cerebral and Cardiovascular Center, Osaka, Japan.</nlm:affiliation>
</affiliation>
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<author><name sortKey="Gregson, John" sort="Gregson, John" uniqKey="Gregson J" first="John" last="Gregson">John Gregson</name>
<affiliation><nlm:affiliation>London School of Hygiene and Tropical Medicine, London, United Kingdom.</nlm:affiliation>
</affiliation>
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<author><name sortKey="Rennie, Kirsten L" sort="Rennie, Kirsten L" uniqKey="Rennie K" first="Kirsten L" last="Rennie">Kirsten L. Rennie</name>
<affiliation><nlm:affiliation>London School of Hygiene and Tropical Medicine, London, United Kingdom; Oxon Epidemiology (United Kingdom), London, United Kingdom.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Hedman, Katarina" sort="Hedman, Katarina" uniqKey="Hedman K" first="Katarina" last="Hedman">Katarina Hedman</name>
<affiliation><nlm:affiliation>AstraZeneca, Gothenburg, Sweden.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Sundell, Karolina Andersson" sort="Sundell, Karolina Andersson" uniqKey="Sundell K" first="Karolina Andersson" last="Sundell">Karolina Andersson Sundell</name>
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</affiliation>
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<affiliation><nlm:affiliation>Terrence Donnelly Heart Centre, St Michael's Hospital, University of Toronto, Toronto, Canada.</nlm:affiliation>
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<series><title level="j">International journal of cardiology</title>
<idno type="eISSN">1874-1754</idno>
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<front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b>
</p>
<p>Evidence is lacking on long-term outcomes in unselected patients surviving the first year following myocardial infarction (MI).</p>
</div>
<div type="abstract" xml:lang="en"><p><b>METHODS AND RESULTS</b>
</p>
<p>The TIGRIS (long-Term rIsk, clinical manaGement and healthcare Resource utilization of stable coronary artery dISease in post-myocardial infarction patients) prospective registry enrolled 9176 eligible patients aged ≥50 years, 1-3 years post-MI, from 25 countries. All had ≥1 risk factor: age ≥ 65 years, diabetes mellitus, second prior MI, multivessel coronary artery disease, chronic kidney disease (CKD). Primary outcome was a composite of MI, unstable angina with urgent revascularization, stroke, or all-cause death at 2-year follow-up. Bleeding requiring hospitalization was also recorded. 9027 patients (98.4%) provided follow-up data: the primary outcome occurred in 621 (7.0%), all-cause mortality in 295 (3.3%), and bleeding in 109 (1.2%) patients. Events accrued linearly over time. In multivariable analyses, qualifying risk factors were associated with increased risk of primary outcome (incidence rate ratio [RR] per 100 patient-years [95% confidence interval]): CKD 2.06 (1.66, 2.55), second prior MI 1.71 (1.38, 2.10), diabetes mellitus 1.63 (1.39, 1.92), age ≥ 65 years 1.53 (1.28, 1.83), and multivessel disease 1.24 (1.05, 1.48). Risk of bleeding events was greater in older patients (vs <65 years) 65-74 years 2.68 (1.53, 4.70), ≥75 years 4.62 (2.57, 8.28), and those with CKD 1.99 (1.18, 3.35).</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSION</b>
</p>
<p>In stable patients recruited 1-3 years post-MI, recurrent cardiovascular and bleeding events accrued linearly over 2 years. Factors independently predictive of ischemic and bleeding events were identified, providing a context for deciding on treatment options.</p>
</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="In-Process" Owner="NLM"><PMID Version="1">32057476</PMID>
<DateRevised><Year>2020</Year>
<Month>11</Month>
<Day>11</Day>
</DateRevised>
<Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1874-1754</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>311</Volume>
<PubDate><Year>2020</Year>
<Month>07</Month>
<Day>15</Day>
</PubDate>
</JournalIssue>
<Title>International journal of cardiology</Title>
<ISOAbbreviation>Int J Cardiol</ISOAbbreviation>
</Journal>
<ArticleTitle>Two-year outcomes among stable high-risk patients following acute MI. Insights from a global registry in 25 countries.</ArticleTitle>
<Pagination><MedlinePgn>7-14</MedlinePgn>
</Pagination>
<ELocationID EIdType="pii" ValidYN="Y">S0167-5273(19)36212-6</ELocationID>
<ELocationID EIdType="doi" ValidYN="Y">10.1016/j.ijcard.2020.01.070</ELocationID>
<Abstract><AbstractText Label="BACKGROUND">Evidence is lacking on long-term outcomes in unselected patients surviving the first year following myocardial infarction (MI).</AbstractText>
<AbstractText Label="METHODS AND RESULTS">The TIGRIS (long-Term rIsk, clinical manaGement and healthcare Resource utilization of stable coronary artery dISease in post-myocardial infarction patients) prospective registry enrolled 9176 eligible patients aged ≥50 years, 1-3 years post-MI, from 25 countries. All had ≥1 risk factor: age ≥ 65 years, diabetes mellitus, second prior MI, multivessel coronary artery disease, chronic kidney disease (CKD). Primary outcome was a composite of MI, unstable angina with urgent revascularization, stroke, or all-cause death at 2-year follow-up. Bleeding requiring hospitalization was also recorded. 9027 patients (98.4%) provided follow-up data: the primary outcome occurred in 621 (7.0%), all-cause mortality in 295 (3.3%), and bleeding in 109 (1.2%) patients. Events accrued linearly over time. In multivariable analyses, qualifying risk factors were associated with increased risk of primary outcome (incidence rate ratio [RR] per 100 patient-years [95% confidence interval]): CKD 2.06 (1.66, 2.55), second prior MI 1.71 (1.38, 2.10), diabetes mellitus 1.63 (1.39, 1.92), age ≥ 65 years 1.53 (1.28, 1.83), and multivessel disease 1.24 (1.05, 1.48). Risk of bleeding events was greater in older patients (vs <65 years) 65-74 years 2.68 (1.53, 4.70), ≥75 years 4.62 (2.57, 8.28), and those with CKD 1.99 (1.18, 3.35).</AbstractText>
<AbstractText Label="CONCLUSION">In stable patients recruited 1-3 years post-MI, recurrent cardiovascular and bleeding events accrued linearly over 2 years. Factors independently predictive of ischemic and bleeding events were identified, providing a context for deciding on treatment options.</AbstractText>
<CopyrightInformation>Copyright © 2020. Published by Elsevier B.V.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Brieger</LastName>
<ForeName>David</ForeName>
<Initials>D</Initials>
<AffiliationInfo><Affiliation>Concord Hospital and University of Sydney, Sydney, Australia. Electronic address: david.brieger@health.nsw.gov.au.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Pocock</LastName>
<ForeName>Stuart J</ForeName>
<Initials>SJ</Initials>
<AffiliationInfo><Affiliation>London School of Hygiene and Tropical Medicine, London, United Kingdom.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Blankenberg</LastName>
<ForeName>Stefan</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Department of General and Interventional, University Heart Center Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner site Hamburg/Lübeck/Kiel, Hamburg, Germany.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Chen</LastName>
<ForeName>Ji Yan</ForeName>
<Initials>JY</Initials>
<AffiliationInfo><Affiliation>Guangdong General Hospital, Provincial Key Laboratory of Coronary Disease, Guangzhou, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Cohen</LastName>
<ForeName>Mauricio G</ForeName>
<Initials>MG</Initials>
<AffiliationInfo><Affiliation>University of Miami Miller School of Medicine, Miami, FL, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Granger</LastName>
<ForeName>Christopher B</ForeName>
<Initials>CB</Initials>
<AffiliationInfo><Affiliation>Duke Clinical Research Institute, Duke University Medical Center, Durham, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Grieve</LastName>
<ForeName>Richard</ForeName>
<Initials>R</Initials>
<AffiliationInfo><Affiliation>London School of Hygiene and Tropical Medicine, London, United Kingdom.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Nicolau</LastName>
<ForeName>Jose C</ForeName>
<Initials>JC</Initials>
<AffiliationInfo><Affiliation>Instituto do Coração (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Simon</LastName>
<ForeName>Tabassome</ForeName>
<Initials>T</Initials>
<AffiliationInfo><Affiliation>Assistance Publique-Hopitaux de Paris (APHP), Department of Clinical Pharmacology and Clinical Research Platform of East of Paris, Paris, France; Sorbonne-Université (UPMC-Paris 06), Paris, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Westermann</LastName>
<ForeName>Dirk</ForeName>
<Initials>D</Initials>
<AffiliationInfo><Affiliation>Department of General and Interventional, University Heart Center Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner site Hamburg/Lübeck/Kiel, Hamburg, Germany.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Yasuda</LastName>
<ForeName>Satoshi</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>National Cerebral and Cardiovascular Center, Osaka, Japan.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Gregson</LastName>
<ForeName>John</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>London School of Hygiene and Tropical Medicine, London, United Kingdom.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Rennie</LastName>
<ForeName>Kirsten L</ForeName>
<Initials>KL</Initials>
<AffiliationInfo><Affiliation>London School of Hygiene and Tropical Medicine, London, United Kingdom; Oxon Epidemiology (United Kingdom), London, United Kingdom.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Hedman</LastName>
<ForeName>Katarina</ForeName>
<Initials>K</Initials>
<AffiliationInfo><Affiliation>AstraZeneca, Gothenburg, Sweden.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Sundell</LastName>
<ForeName>Karolina Andersson</ForeName>
<Initials>KA</Initials>
<AffiliationInfo><Affiliation>AstraZeneca, Gothenburg, Sweden.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Goodman</LastName>
<ForeName>Shaun G</ForeName>
<Initials>SG</Initials>
<AffiliationInfo><Affiliation>Terrence Donnelly Heart Centre, St Michael's Hospital, University of Toronto, Toronto, Canada.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic"><Year>2020</Year>
<Month>01</Month>
<Day>28</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo><Country>Netherlands</Country>
<MedlineTA>Int J Cardiol</MedlineTA>
<NlmUniqueID>8200291</NlmUniqueID>
<ISSNLinking>0167-5273</ISSNLinking>
</MedlineJournalInfo>
<CitationSubset>IM</CitationSubset>
<CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>Int J Cardiol. 2020 Oct 1;316:54-56</RefSource>
<PMID Version="1">32360648</PMID>
</CommentsCorrections>
</CommentsCorrectionsList>
<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">Myocardial infarction</Keyword>
<Keyword MajorTopicYN="Y">Observational</Keyword>
<Keyword MajorTopicYN="Y">Stable coronary artery disease</Keyword>
</KeywordList>
<CoiStatement>Declaration of competing interest D.B. Speaker/consulting honoraria and/or research grant support from AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly and Company, Merck, Novartis, Sanofi. S.J.P. Statistical consulting honoraria from AstraZeneca. S.B. Speaker/consulting honoraria and/or research grant support from Abbott, Abbott Diagnostics, AstraZeneca, Bayer, Boehringer Ingelheim, Medtronic, Novartis, Pfizer, Roche, Siemens, Siemens Diagnostics, Thermo Fisher Scientific. J.-Y.C. Research grant support from AstraZeneca; consulting honoraria from MicroPort, APT Medical and JW Medical. M.G.C. Speaker/consulting honoraria and/or research grant support from AstraZeneca, Medtronic, Abiomed, Merit Medical. C.B.G. Consulting honoraria and/or research grant support from Armetheon, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Daiichi Sankyo, Eli Lilly and Company, Gilead, GlaxoSmithKline, F. Hoffmann-La Roche, Janssen Pharmaceuticals, Metronic, Pfizer, Salix Pharmaceuticals, Sanofi, Takeda Pharmaceutical Company, The Medicines Company. R.G. None. J.C.N. Speaker/consulting honoraria and/or research grant support from Amgen, AstraZeneca, Bayer, BMS, CLS Behring, Pfizer, Sanofi. T.S. Speaker/consulting honoraria and/or research grant support from Astellas, Amgen Inc., AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly and Company, GlaxoSmithKline, Merck, Novartis, Pfizer, Sanofi. D.W. Speaker/consulting honoraria and/or research grant support from AstraZeneca, Bayer, Berlin-Chemie, Biotronik, Novartis. S.Y. Speaker/consulting honoraria and/or research grant support from Takeda Pharmaceutical Company, Daiichi-Sankyo, AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb. J.G. Grants from AstraZeneca during the conduct of the study and outside the submitted work. K.L.R. Employee of OXON Epidemiology Ltd., and paid consultant to AstraZeneca in connection with the conduct, data management and analyses of this study. K.H. Employee of AstraZeneca. K.A.S. Employee of AstraZeneca. S.G.G. Speaker/consulting honoraria and/or research grant support from Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, CSL Behring, Daiichi Sankyo, Eli Lilly and Company, Fenix Group International, Ferring Pharmaceuticals, GlaxoSmithKline, Janssen/Johnson & Johnson, Luitpold Pharmaceuticals, Matrizyme, Merck, Novartis, Pfizer, Regeneron, Sanofi, Servier, Tenax Pharmaceuticals, HLS Therapeutics, Novo-Nordisk.</CoiStatement>
</MedlineCitation>
<PubmedData><History><PubMedPubDate PubStatus="received"><Year>2019</Year>
<Month>12</Month>
<Day>23</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="accepted"><Year>2020</Year>
<Month>01</Month>
<Day>27</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="pubmed"><Year>2020</Year>
<Month>2</Month>
<Day>15</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="medline"><Year>2020</Year>
<Month>2</Month>
<Day>15</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="entrez"><Year>2020</Year>
<Month>2</Month>
<Day>15</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
</History>
<PublicationStatus>ppublish</PublicationStatus>
<ArticleIdList><ArticleId IdType="pubmed">32057476</ArticleId>
<ArticleId IdType="pii">S0167-5273(19)36212-6</ArticleId>
<ArticleId IdType="doi">10.1016/j.ijcard.2020.01.070</ArticleId>
</ArticleIdList>
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