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van Domburg RT, Deckers JW, van Bergen PF, et al. Prognostic significance of nonfatal myocardial reinfarction in survivors of a first infarction. Neth Heart J. 2001;9(4):166-171
van Domburg, R. T., Deckers, J. W., van Bergen, P. F., Azar, A. J., Jonker, J. J., & Simoons, M. L. (2001). Prognostic significance of nonfatal myocardial reinfarction in survivors of a first infarction. Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation, 9(4), 166-171.
van Domburg, R T, et al. "Prognostic significance of nonfatal myocardial reinfarction in survivors of a first infarction." Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation vol. 9,4 (2001): 166-171.
van Domburg RT, Deckers JW, van Bergen PF, Azar AJ, Jonker JJ, Simoons ML. Prognostic significance of nonfatal myocardial reinfarction in survivors of a first infarction. Neth Heart J. 2001 Aug;9(4):166-171. PMID: 25696720; PMCID: PMC2499631.
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Neth Heart J. 2001 Aug;9(4):166-171.

Prognostic significance of nonfatal myocardial reinfarction in survivors of a first infarction.

Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation

R T van Domburg, J W Deckers, P F M M van Bergen, A J Azar, J J C Jonker, M L Simoons

PMID: 25696720 PMCID: PMC2499631

Abstract

BACKGROUND: Patients who develop a reinfarction are at increased risk for subsequent reinfarctions and death. However, follow-up studies in these patients are rare.

OBJECTIVE: The purpose of this study was to examine the risk of mortality after a first myocardial reinfarction and to determine the independent contribution of nonfatal reinfarction to the risk of subsequent mortality.

METHODS: The prognostic value of nonfatal reinfarction was assessed in a large series (n=3097) of patients with a first myocardial infarction who participated in the ASPECT trial, comparing coumarin or matching placebo.

RESULTS: A second myocardial infarction was documented in 299 patients (82% Q-wave infarctions), 45 (15%) of which were fatal. Of the 254 nonfatal reinfarctions, 31 patients (12%) died during subsequent follow-up. After adjustment for baseline characteristics, the relative risks of nonfatal reinfarction for subsequent cardiac mortality at one month were: 2.90 (1.49-5.64), at one year: 2.50 (1.47-4.23) and at three years: 2.71 (1.77-4.17). Rates of death or a second reinfarction in patients who did not undergo a revascularisation procedure after a first reinfarction were almost three times higher than in patients who did have PTCA or bypass surgery after a reinfarction (38% versus 14%; p<0.0001).

CONCLUSION: This study population with three-year follow-up confirms that nonfatal reinfarction carries a strong and independent risk for recurrent reinfarction and subsequent mortality. Thus, prevention of reinfarction by intensive treatment might contribute in reduction of mortality.

Keywords: mortality; myocardial infarction; prognosis; revascularisation; risk factors

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