Early revascularisation substantially improves one-year survival after a first acute myocardial infarction (AMI).
Investigators studying a prospective cohort of AMI patients admitted to 61 Swedish hospitals between 1995 and 1998 say early invasive treatment especially improves mortality in patients with non-ST-segment elevation MI (NSTEMI).
Because the study was based on individual patient data rather than on group statistics, researchers from University Hospital of Linkoping and University Hospital of Uppsala say they were able to adjust for multiple confounding factors.
A total of 36,294 patients out of 42,422 AMI patients admitted to one of the participating Swedish coronary care units had a first AMI. Of these, 21,912 were younger than age 80 years and survived for at least 14 days.
Investigators analysed one-year mortality data on these 21,912 patients obtained from the Swedish National Cause of Death Register. A total of 2,554 patients had revascularisation within 14 days of the index AMI; 19,358 did not. At one year, unadjusted mortality was 3.3 percent (84 deaths) in the revascularisation group and 9.0 percent (1,751 deaths) in the
patients treated conservatively.
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