Original Article

Short and Long-term Survival Rates following Myocardial Infarction and its Predictive Factors: A Study Using National Registry Data


Background: Coronary artery disease is the most common cause of death worldwide as well as in Iran. The present study was designed to predict short and long-term survival rates after the first episode of myocardial infarction (MI).

Methods: The current research is a retrospective cohort study. The data were collected from the Myocardial Infarction Registry of Iran in a 12-month period leading to March 20, 2014. The variables analyzed included smoking status, past medical history of chronic heart disease, hypertension, diabetes, hyperlipidemia, signs and symptoms during an attack, post-MI complications during hospitalization, the occurrence of arrhythmias, the location of MI, and the place of residence. Survival rates and predictive factors were estimated by the Kaplan–Meier method, the log-rank test, and the Cox model.

Results: Totally, 21 181 patients with the first MI were studied. There were 15 328 men (72.4%), and the mean age of the study population was 62.10±13.42 years. During a 1-year period following MI, 2479 patients (11.7%) died. Overall, the survival rates at 28 days, 6 months, and 1 year were estimated to be 0.95 (95% CI: 0.95 to 0.96), 0.90 (95% CI: 0.90 to 0.91), and 0.88 (95% CI: 0.88 to 0.89). After the confounding factors were controlled, history of chronic heart disease (p<0.001), hypertension (p<0.001), and diabetes (p<0.001) had a significant relationship with an increased risk of death and history of hyperlipidemia (p<0.001) and inferior wall MI (p<0.001) had a significant relationship with a decreased risk of death.

Conclusion: The results of this study provide evidence for health policy-makers and physicians on the link between MI and its predictive factors.

1. Sarraf-Zadegan N, Boshtam M, Malekafzali H, Bashardoost N, Sayed-Tabatabaei FA, Rafiei M, Khalili A, Mostafavi S, Khami M, Hassanvand R. Secular trends in cardiovascular mortality in Iran, with special reference to Isfahan. Acta Cardiol. 1999 Dec;54(6):327-33. PMID: 10672288.
2. Kim AS, Johnston SC. Global variation in the relative burden of stroke and ischemic heart disease. Circulation 2011;124:314-323.
3. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med 2006;3:e442.
4. Abildstrom SZ, Rasmussen S, Rosén M, Madsen M. Trends in incidence and case fatality rates of acute myocardial infarction in Denmark and Sweden. Heart 2003;89:507-511.
5. Yusuf S, Zucker D, Peduzzi P, Fisher LD, Takaro T, Kennedy JW, Davis K, Killip T, Passamani E, Norris R, et al. Effect of coronary artery bypass graft surgery on survival: overview of 10-year results from randomised trials by the Coronary Artery Bypass Graft Surgery Trialists Collaboration. Lancet 1994;344:563-570.
6. Maynard C, Every NR, Martin JS, Kudenchuk PJ, Weaver WD. Association of gender and survival in patients with acute myocardial infarction. Arch Intern Med 1997;157:1379-1384.
7. Ahmadi A, Soori H, Mehrabi Y, Etemad K, Samavat T, Khaledifar A. Incidence of acute myocardial infarction in Islamic Republic of Iran: a study using national registry data in 2012. East Mediterr Health J 2015;21:5-12.
8. Gomez JF, Zareba W, Moss AJ, McNitt S, Hall WJ. Prognostic value of location and type of myocardial infarction in the setting of advanced left ventricular dysfunction. Am J Cardiol 2007;99:642-646.
9. Mohammadian M, Hosseini S, Salehiniya H, Sadeghi M, Sarrafzadegan N, Roohafza HR, Khazaei S, Soltani S, Sarrafkia A, Golshahi J, Mohammadian-Hafshejani A. Prognostic factors of 28 days survival rate in patients with a first acute myocardial infarction based on gender in Isfahan, Iran (2000-2009). ARYA Atheroscler 2015;11:332-3340.
10. Toluey M, Ghaffari S, Tajlil A, Nasiri B, Rostami A. The impact of cigarette smoking on infarct location and in-hospital outcome following acute ST-elevation myocardial infarction. J Cardiovasc Thorac Res 2019;11:209-215.
11. Abdolazimi M, Khosravi A, Sadeghi M, Mohammadian-Hafshejani A, Sarrafzadegan N, Salehiniya H, Golshahi J. Predictive factors of short-term survival from acute myocardial infarction in early and late patients in Isfahan and Najafabad, Iran. ARYA Atheroscler 2016;12:59-67.
12. Abduelkarem AR, El-Shareif HJ, Sharif SI. Evaluation of risk factors in acute myocardial infarction patients admitted to the coronary care unit, Tripoli Medical Centre, Libya. East Mediterr Health J 2012;18:332-336.
13. Vaur L, Danchin N, Genès N, Dubroca I, Etienne S, Ferrières J, Cambou JP. Epidemiology of myocardial infarction in France: therapeutic and prognostic implications of heart failure during the acute phase. Am Heart J 1999;137:49-58.
14. Kubota I, Ito H, Yokoyama K, Yasumura S, Tomoike H. Early mortality after acute myocardial infarction: observational study in Yamagata, 1993-1995. Jpn Circ J 1998;62:414-418.
15. You J, Condon JR, Zhao Y, Guthridge S. Incidence and survival after acute myocardial infarction in Indigenous and non-Indigenous people in the Northern Territory, 1992-2004. Med J Aust 2009;190:298-302.
16. Martin CA, Thompson PL, Armstrong BK, Hobbs MS, de Klerk N. Long-term prognosis after recovery from myocardial infarction: a nine year follow-up of the Perth Coronary Register. Circulation 1983;68:961-969.
17. Rosengren A, Spetz CL, Köster M, Hammar N, Alfredsson L, Rosén M. Sex differences in survival after myocardial infarction in Sweden; data from the Swedish National Acute Myocardial Infarction Register. Eur Heart J 2001;22:314-322.
18. Gottlieb S, Moss AJ, McDermott M, Eberly S. Comparison of posthospital survival after acute myocardial infarction in women and men. Am J Cardiol 1994;74:727-730.
19. van Oeffelen AA, Agyemang C, Bots ML, Stronks K, Koopman C, van Rossem L, Vaartjes I. The relation between socioeconomic status and short-term mortality after acute myocardial infarction persists in the elderly: results from a nationwide study. Eur J Epidemiol 2012;27:605-613.
20. Stevenson R, Ranjadayalan K, Wilkinson P, Roberts R, Timmis AD. Short and long term prognosis of acute myocardial infarction since introduction of thrombolysis. BMJ 1993;307:349-353.
21. Johansson S, Rosengren A, Young K, Jennings E. Mortality and morbidity trends after the first year in survivors of acute myocardial infarction: a systematic review. BMC Cardiovasc Disord 2017;17:53.
22. Lisowska A, Makarewicz-Wujec M, Filipiak KJ. Risk factors, prognosis, and secondary prevention of myocardial infarction in young adults in Poland. Kardiol Pol 2016;74:1148-1153.
23. Gerber Y, Rosen LJ, Goldbourt U, Benyamini Y, Drory Y; Israel Study Group on First Acute Myocardial Infarction. Smoking status and long-term survival after first acute myocardial infarction a population-based cohort study. J Am Coll Cardiol 2009;54:2382-7238.
24. Barbash GI, Reiner J, White HD, Wilcox RG, Armstrong PW, Sadowski Z, Morris D, Aylward P, Woodlief LH, Topol EJ. Evaluation of paradoxic beneficial effects of smoking in patients receiving thrombolytic therapy for acute myocardial infarction: mechanism of the "smoker's paradox" from the GUSTO-I trial, with angiographic insights. Global Utilization of Streptokinase and Tissue-Plasminogen Activator for Occluded Coronary Arteries. J Am Coll Cardiol 1995;26:1222-1229.
25. Gottlieb S, Boyko V, Zahger D, Balkin J, Hod H, Pelled B, Stern S, Behar S. Smoking and prognosis after acute myocardial infarction in the thrombolytic era (Israeli Thrombolytic National Survey). J Am Coll Cardiol 1996;28:1506-1513.
26. Tian L, Yang Y, Zhu J, Liu L, Liang Y, Li J, Yu B. Impact of Previous Stroke on Short-Term Myocardial Reinfarction in Patients With Acute ST Segment Elevation Myocardial Infarction: An Observational Multicenter Study. Medicine (Baltimore) 2016;95:e2742.
27. Haim M, Hod H, Reisin L, Kornowski R, Reicher-Reiss H, Goldbourt U, Boyko V, Behar S. Comparison of short- and long-term prognosis in patients with anterior wall versus inferior or lateral wall non-Q-wave acute myocardial infarction. Secondary Prevention Reinfarction Israeli Nifedipine Trial (SPRINT) Study Group. Am J Cardiol 1997;79:717-721.
28. Arós F, Heras M, Vila J, Sanz H, Ferreira-González I, Permanyer-Miralda G, Cuñat J, López-Bescós L, Cabadés A, Loma-Osorio A, Marrugat J; en representación de los investigadores de los registros PRIAMHO I, II y MASCARA. Reducción de la mortalidad precoz y a 6 meses en pacientes con IAM en el periodo 1995-2005. Datos de los registros PRIAMHO I, II y MASCARA [Reduction in 28 days and 6 months of acute myocardial infarction mortality from 1995 to 2005. Data from PRIAMHO I, II and MASCARA registries]. Rev Esp Cardiol 2011;64:972-980.
IssueVol 16 No 2 (2021): J Teh Univ Heart Ctr QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/jthc.v16i2.7387
Cox Regression Myocardial infarction Survival rate Hypertension

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Mozaffarian S, Etemad K, Aghaali M, Khodakarim S, Sotoodeh Ghorbani S, Hashemi Nazari SS. Short and Long-term Survival Rates following Myocardial Infarction and its Predictive Factors: A Study Using National Registry Data. J Tehran Heart Cent. 2021;16(2):68-74.