Coronary disease & ACSCohort study
Long-Term Cardiovascular and Noncardiovascular Mortality After Acute Coronary Syndrome
- Multicentre cohort study
- competing-risks analysis (Fine and Gray)
- 12-month landmark analysis
Authors' conclusion
This national study demonstrates a transition in post-ACS mortality from CV to non-CV causes over time, with malignancy emerging as the leading cause of late-term death.
Study context
- Population
- Adults (≥18 y) discharged with Acute Coronary Syndrome (ACS), China Cardiovascular Association Database-Chest Pain Center, 2018–20211,074,289 (68.7%) men
- Participants
- 1,562,956 adults
- Outcome
- All-cause mortality (CV and non-CV death as competing events)
Main finding
As reported in the abstract
Cumulative incidence of CV vs non-CV mortality after ACS discharge
- Cardiovascular (CV) mortality at 1-month discharge
- 1.24%
- Non-CV mortality at 1-month discharge
- 0.26%
- Ischemic heart disease share of CV deaths
- 68.5%
- Malignancy share of non-CV deaths
- 38.3%
- Chronic pulmonary disease share of non-CV deaths
- 15.8%
Observational data: associations, not effects.
Further findings
Predictors of death (Fine and Gray competing-risks regression)
| Comparison | sHR (95% CI) | |
|---|---|---|
| Age ≥65 years · leading predictors of death | 3.78 (3.72–3.849) | |
| chronic kidney disease · leading predictors of death | 2.07 (2.03–2.11) | |
| chronic heart failure · leading predictors of death | 1.99 (1.96–2.02) | |
| 0.20.5125Subdistribution hazard ratio (log scale) |
Causes of death
- Ischemic heart disease (share of CV death)
- 68.5%
- Malignancy (share of non-CV death)
- 38.3%
- Chronic pulmonary disease (share of non-CV death)
- 15.8%
Lipid-lowering therapy
- Associated with lower risks of all-cause, CV and non-CV death
Original publication
Long-Term Cardiovascular and Noncardiovascular Mortality After Acute Coronary Syndrome. J Am Coll Cardiol. Published 6 February 2026. doi:10.1016/j.jacc.2025.12.064
Summarised from the published abstract; every number is checked against it