Long-Term Cardiac Death Rate Drops in Acute Heart Attack Patients with Stents

Secondary prevention after heart attack should focus more on the risk of noncardiac death

Contact: Katharine Glenn, kglenn@acc.org, 202-375-6472

WASHINGTON (Nov. 10, 2014) — Heart attack patients treated quickly with angioplasty and stent placement who survived the first month after treatment were less likely to die from heart disease but remain vulnerable to other risk factors, according to a study published online today in the Journal of the American College of Cardiology.

Researchers from the University of Copenhagen’s Department of Cardiology at Rigshospitalet in Denmark, looked at 2,804 patients treated with acute angioplasty and stents—known as primary percutaneous coronary interventions or PCI—from July 1998 to July 2008. Researchers followed patients for a median of 4.7 years after the procedure.

The study found cardiac-related death was high during the first month following treatment but fell significantly after 30 days to an annual rate of less than 1.5 percent. While the cardiac prognosis was excellent, the causes of death after a month were noncardiac nearly 65 percent of the time. The risk factors that contributed to the initial heart attack were superseded by others, putting the patient at higher risk of future noncardiac events such as cancer and lung conditions.

“The very low long-term cardiac death rate might be explained to some extent by secondary prevention programs. How non-cardiovascular death is influenced by cardiovascular disease needs further study. Our findings encourage continued concentration of resources in prevention and particularly the treatment of patients in the early phases of a heart attack,” said the study’s lead author, Frants Pedersen, M.D., PhD, of Rigshospitalet at the University of Copenhagen. “Medical professionals should not only look at the factors that put the patient at risk for a heart attack but also work to prevent noncardiac diseases on top of the secondary prevention towards cardiac events after a PCI.”

In an accompanying editorial, Mark Hlatky, M.D., of Stanford University School of Medicine, said the study indicates clinicians should take a holistic view of patients. “The reduction in mortality from primary PCI can only be a short-term success, and in the long-term, other forces of mortality will come to the fore,” Hlatky wrote. “We need to recognize the factors, both cardiac and noncardiac, that pose the greatest risk to patients who survive an MI, and initiate the therapies and behavior changes that will reduce the risk of late mortality.” 

The American College of Cardiology is a 47,000-member medical society that is the professional home for the entire cardiovascular care team. The mission of the College is to transform cardiovascular care and to improve heart health. The ACC leads in the formation of health policy, standards and guidelines. The College operates national registries to measure and improve care, provides professional medical education, disseminates cardiovascular research and bestows credentials upon cardiovascular specialists who meet stringent qualifications. For more information, visit cardiosource.org/ACC.

The Journal of the American College of Cardiology, which publishes peer-reviewed research on all aspects of cardiovascular disease, is the most widely read cardiovascular journal worldwide. JACC is ranked No. 1 among cardiovascular journals worldwide for its scientific impact.

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