Heart and Vessels

, Volume 24, Issue 5, pp 347–351

Clinical features of early recurrent myocardial infarction

  • Kenichi Sakakura
  • Norifumi Kubo
  • Junya Ako
  • Nahoko Ikeda
  • Hiroshi Funayama
  • Taishi Hirahara
  • Hiroshi Wada
  • Yoshitaka Sugawara
  • Takanori Yasu
  • Masanobu Kawakami
  • Shin-ichi Momomura
Original Article

Abstract

Recurrence of myocardial infarction, especially when occurring early after the prior one, carries a significant morbidity and mortality rate. The aim of this study was to investigate the characteristics of patients who experienced recurrence under secondary prevention therapy. Case record review identified myocardial infarction patients who had a history of previous myocardial infarction within 5 years. Hospital chart records, initial laboratory data, medications, and type of infarction were reviewed. Patients were divided into two groups according to the interval of recurrence: an early group (recurrence within 1 year), and a late group (recurrence after more than 1 year). A total of 89 patients were included in the analysis; 40 patients in the early group, and 49 patients in the late group. Mean age in the early group and late groups was 67.3 ± 11.9 and 59.4 ± 8.9, respectively (P = 0.001). Mean body mass index in the early and late groups was 22.1 ± 3.6 and 25.0 ± 3.3, respectively (P < 0.001). There were fewer current smokers in the early group (7.5% vs 44.9%, P < 0.001) and more stent thrombosis (17.5% vs 2%, P = 0.02), as compared with the late group. The in-hospital mortality rate tended to be higher in the early group (7.5% vs 0%, P = 0.09). Multiple logistic regression revealed that smoking status (odds ratio [OR] 0.09, 95% confidence interval [CI] 0.02−0.49, P = 0.005), HDL cholesterol level (5 mg/dl increase: OR 1.34, 95% CI 1.04−1.74, P = 0.03), and stent thrombosis (OR 35.59, 95% CI 2.13−595.49, P = 0.01) had significant associations with early recurrence. Early recurrence of myocardial infarction was associated with stent thrombosis, a higher HDL cholesterol level, and a lower frequency of smoking. Early recurrence had a trend toward higher mortality than late recurrence.

Key words

Myocardial infarction Recurrence Secondary prevention 

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References

  1. 1.
    Weinblatt E, Shapiro S, Frank CW, Sager RV (1968) Prognosis of men after first myocardial infarction: mortality and first recurrence in relation to selected parameters. Am J Public Health Nations Health 58:1329–1347PubMedGoogle Scholar
  2. 2.
    Marcus FI, Cobb LA, Edwards JE, Kuller L, Moss AJ, Bigger JT Jr, Fleiss JL, Rolnitzky L, Serokman R (1988) Mechanism of death and prevalence of myocardial ischemic symptoms in the terminal event after acute myocardial infarction. Am J Cardiol 61:8–15PubMedCrossRefGoogle Scholar
  3. 3.
    Orn S, Cleland JG, Romo M, Kjekshus J, Dickstein K (2005) Recurrent infarction causes the most deaths following myocardial infarction with left ventricular dysfunction. Am J Med 118:752–758PubMedCrossRefGoogle Scholar
  4. 4.
    Lowe GD, Machado SG, Krol WF, Barton BA, Forbes CD (1985) White blood cell count and haematocrit as predictors of coronary recurrence after myocardial infarction. Thromb Haemost 54: 700–703PubMedGoogle Scholar
  5. 5.
    Andersen SS, Hansen ML, Gislason GH, Folke F, Schramm TK, Fosbol E, Sorensen R, Rasmussen S, Abildstrom SZ, Madsen M, Kober L, Torp-Pedersen C (2008) Mortality and reinfarction among patients using different beta-blockers for secondary prevention after a myocardial infarction. Cardiology 112:144–150PubMedCrossRefGoogle Scholar
  6. 6.
    Gislason GH, Jacobsen S, Rasmussen JN, Rasmussen S, Buch P, Friberg J, Schramm TK, Abildstrom SZ, Kober L, Madsen M, Torp-Pedersen C (2006) Risk of death or reinfarction associated with the use of selective cyclooxygenase-2 inhibitors and nonselective nonsteroidal antiinflammatory drugs after acute myocardial infarction. Circulation 113:2906–2913PubMedCrossRefGoogle Scholar
  7. 7.
    Kornowski R, Goldbourt U, Zion M, Mandelzweig L, Kaplinsky E, Levo Y, Behar S (1993) Predictors and long-term prognostic significance of recurrent infarction in the year after a first myocardial infarction. SPRINT Study Group. Am J Cardiol 72:883–888Google Scholar
  8. 8.
    Mauri L, Hsieh WH, Massaro JM, Ho KK, D’Agostino R, Cutlip DE (2007) Stent thrombosis in randomized clinical trials of drugeluting stents. N Engl J Med 356:1020–1029PubMedCrossRefGoogle Scholar
  9. 9.
    Cutlip DE, Windecker S, Mehran R, Boam A, Cohen DJ, van Es GA, Steg PG, Morel MA, Mauri L, Vranckx P, McFadden E, Lansky A, Hamon M, Krucoff MW, Serruys PW (2007) Clinical end points in coronary stent trials: a case for standardized definitions. Circulation 115:2344–2351PubMedCrossRefGoogle Scholar
  10. 10.
    Andrikopoulos GK, Richter DJ, Dilaveris PE, Pipilis A, Zaharoulis A, Gialafos JE, Toutouzas PK, Chimonas ET (2001) In-hospital mortality of habitual cigarette smokers after acute myocardial infarction; the “smoker’s paradox” in a countrywide study. Eur Heart J 22:776–784PubMedCrossRefGoogle Scholar
  11. 11.
    Sharrett AR, Ballantyne CM, Coady SA, Heiss G, Sorlie PD, Catellier D, Patsch W (2001) Coronary heart disease prediction from lipoprotein cholesterol levels, triglycerides, lipoprotein(a), apolipoproteins A-I and B, and HDL density subfractions: The Atherosclerosis Risk in Communities (ARIC) Study. Circulation 104:1108–1113PubMedCrossRefGoogle Scholar
  12. 12.
    Gordon T, Castelli WP, Hjortland MC, Kannel WB, Dawber TR (1977) High density lipoprotein as a protective factor against coronary heart disease. The Framingham Study. Am J Med 62: 707–714Google Scholar
  13. 13.
    Turner RC, Millns H, Neil HA, Stratton IM, Manley SE, Matthews DR, Holman RR (1998) Risk factors for coronary artery disease in non-insulin dependent diabetes mellitus: United Kingdom Prospective Diabetes Study (UKPDS: 23). BMJ 316:823–828PubMedGoogle Scholar
  14. 14.
    Liuzzo G, Biasucci LM, Trotta G, Brugaletta S, Pinnelli M, Digianuario G, Rizzello V, Rebuzzi AG, Rumi C, Maseri A, Crea F (2007) Unusual CD4+CD28 null T lymphocytes and recurrence of acute coronary events. J Am Coll Cardiol 50:1450–1458PubMedCrossRefGoogle Scholar
  15. 15.
    Erzen B, Sabovic M, Sebestjen M, Poredos P (2007) Endothelial dysfunction, intima-media thickness, ankle-brachial pressure index, and pulse pressure in young post-myocardial infarction patients with various expressions of classical risk factors. Heart Vessels 22:215–222PubMedCrossRefGoogle Scholar
  16. 16.
    Noda M, Takagi A, Kuwatsuru R, Mitsuhashi N, Kasanuki H (2008) Prognostic significance of multiple-detector computed tomography in conjunction with TIMI risk score for patients with non-ST elevation acute coronary syndrome. Heart Vessels 23: 161–166PubMedCrossRefGoogle Scholar
  17. 17.
    Bavry AA, Kumbhani DJ, Helton TJ, Borek PP, Mood GR, Bhatt DL (2006) Late thrombosis of drug-eluting stents: a meta-analysis of randomized clinical trials. Am J Med 119:1056–1061PubMedCrossRefGoogle Scholar
  18. 18.
    Stettler C, Wandel S, Allemann S, Kastrati A, Morice MC, Schomig A, Pfisterer ME, Stone GW, Leon MB, de Lezo JS, Goy JJ, Park SJ, Sabate M, Suttorp MJ, Kelbaek H, Spaulding C, Menichelli M, Vermeersch P, Dirksen MT, Cervinka P, Petronio AS, Nordmann AJ, Diem P, Meier B, Zwahlen M, Reichenbach S, Trelle S, Windecker S, Juni P (2007) Outcomes associated with drug-eluting and bare-metal stents: a collaborative network meta-analysis. Lancet 370:937–948PubMedCrossRefGoogle Scholar
  19. 19.
    Silva JA, Nunez E, White CJ, Collins TJ, Jenkins JS, Zhang S, Jain SP, Ramee SR (1999) Predictors of stent thrombosis after primary stenting for acute myocardial infarction. Catheter Cardiovasc Interv 47:415–422PubMedCrossRefGoogle Scholar
  20. 20.
    Schomig A, Neumann FJ, Kastrati A, Schuhlen H, Blasini R, Hadamitzky M, Walter H, Zitzmann-Roth EM, Richardt G, Alt E, Schmitt C, Ulm K (1996) A randomized comparison of antiplatelet and anticoagulant therapy after the placement of coronary-artery stents. N Engl J Med 334:1084–1089PubMedCrossRefGoogle Scholar
  21. 21.
    Leon MB, Baim DS, Popma JJ, Gordon PC, Cutlip DE, Ho KK, Giambartolomei A, Diver DJ, Lasorda DM, Williams DO, Pocock SJ, Kuntz RE (1998) A clinical trial comparing three antithrombotic-drug regimens after coronary-artery stenting. Stent Anticoagulation Restenosis Study Investigators. N Engl J Med 339:1665–1671PubMedCrossRefGoogle Scholar
  22. 22.
    Kasai T, Miyauchi K, Kajimoto K, Kubota N, Kurata T, Daida H (2008) Influence of diabetes on >10-year outcomes after percutaneous coronary intervention. Heart Vessels 23:149–154PubMedCrossRefGoogle Scholar

Copyright information

© Springer Japan 2009

Authors and Affiliations

  • Kenichi Sakakura
    • 1
  • Norifumi Kubo
    • 1
  • Junya Ako
    • 2
  • Nahoko Ikeda
    • 1
  • Hiroshi Funayama
    • 1
  • Taishi Hirahara
    • 1
  • Hiroshi Wada
    • 1
  • Yoshitaka Sugawara
    • 1
  • Takanori Yasu
    • 1
  • Masanobu Kawakami
    • 1
  • Shin-ichi Momomura
    • 1
  1. 1.Division of Cardiovascular Medicine, Department of Integrated Medicine IJichi Medical University Saitama Medical CenterOmiya, SaitamaJapan
  2. 2.Division of Cardiovascular MedicineStanford University School of MedicineStanfordUSA

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