Læknablaðið - nov. 2018, Side 17

LÆKNAblaðið 2018/104 497
R A N N S Ó K N
Einar Logi Snorrason
Bergrós Kristín Jóhannesdóttir
Thor Aspelund
Vilmundur Gudnason
Karl Andersen
Introduction: Despite the decreasing incidence rate of acute
coronary syndromes worldwide, the incidence of NSTEMI (Non-
ST elevation myocardial infarction) has increased relative to
STEMI (ST elevation myocardial infarction). The aim of this study
was to compare long-term survival rates of NSTEMI and STEMI
patients and to explore the effects of risk factors on survival.
Material and methods: All patients hospitaized for acute
myocardial infarction at Landspitali University Hospital during
the calendar year of 2006 were included in the study. Information
about risk factors was obtained using electronic medical records.
The primary endpoint was all cause mortality, the secondary end-
point was defined as death or myocardial infartion. Patients were
followed up to January 1st 2015.
Results: Among 447 patients diagnosed with acute myocardial
infarction in Iceland in 2006, 280 patients were diagnosed with
NSTEMI (I21.4) and 167 with STEMI (I21, I21.9). NSTEMI and
STEMI incidence rates per 100.000 inhabitants in Iceland were
91.3 and 55.9, respectively. The mean age of NSTEMI patients
was 73.0 years, women were on average 8.4 years older than
men. The mean age of STEMI patients was 65.3 years, women
were on average 7.3 years older than men. The five-year survi-
val rate for NSTEMI patients was 51%, 42% among women and
57% among men. The five-year survival rate for STEMI patients
was 77%, 68% among women and 80% among men. Five year
age-adjusted survival rates were higher for STEMI than NSTEMI
(logrank: p <0.01).
Conclusion: The incidence of NSTEMI was higher than that of
STEMI in Iceland in 2006. The worse prognosis of women as
compared to men was due to the higher mean age of women.
Overall, long-term survival of NSTEMI patients was worse than
that of STEMI patients even after adjustment for difference in
age.
Long-term survival of patients with acute myocardial infarction in Iceland
ENGLISH SUMMARY
Key words: acute myocardial infarction, prognosis, long term survival, ST elevation myocardial infarction, Non ST elevation myocardial infarction.
Correspondence: Karl Andersen, andersen@landspitali.is
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