Coronary disease & ACSCohort study
Excess Mortality and Loss of Life Expectancy After Myocardial Infarction: A Registry-Based Matched Cohort Study
- Registry-based matched cohort study
- nationwide registry
- up to 5 matched comparators per case (age, sex, region)
- flexible parametric survival models
Authors' conclusion
LOLE is higher in younger individuals, women, and those with reduced LVEF, but is attenuated when adjusting for comorbidities and risk factors. Advances in MI treatment during the past 30 years have almost halved LOLE, with no clear sign of leveling off to a plateau.
Study context
- Population
- Patients with a first myocardial infarction (MI), nationwide SWEDEHEART registry, 1991–2022matched cohort
- Participants
- 335,748 vs 1,625,396
- Exposure
- Patients with first MI vs matched comparators without previous MI
- MIn = 335,748
- Comparatorsn = 1,625,396reference
- Outcome
- Excess mortality and mean loss of life expectancy (LOLE) by index year, age, sex and LVEF
Main finding
As reported in the abstract
Mean LOLE · 2022
50-year-old women, reduced left ventricular ejection fraction (LVEF): unadjusted vs adjusted mean loss of life expectancy (LOLE)
11.1 and 9.5 years
80-year-old men, preserved LVEF: unadjusted vs adjusted mean LOLE
5 and 3.7 months
Observational data: associations, not effects.
Further findings
Change in adjusted mean LOLE, 1992 to 2022
- Adjusted mean LOLE decrease
- 36% to 55%
- 50-year-old women
- from 4.4 to 2.0 years
- 50-year-old men
- from 3.3 to 1.9 years
- 80-year-old women
- from 1.7 to 1.0 years
- 80-year-old men
- from 1.4 to 0.9 years
Original publication
Excess Mortality and Loss of Life Expectancy After Myocardial Infarction: A Registry-Based Matched Cohort Study. Circulation. Published 5 July 2024. doi:10.1161/circulationaha.124.068739
Summarised from the published abstract; every number is checked against it