Predictors of nonfetal reinfarction in survivors of myocardial infarction after thrombolysis. Results of the gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI-2) data base

Alberto Volpi, Claudio De Vita, Maria Grazia Franzosi, Enrico Geraci, Aldo Pietro Maggioni, Francesco Mauri, Eva Negri, Eugenio Santoro, Luigi Tavazzi, Gianni Tognoni

Research output: Contribution to journalArticle

Abstract

Objectives. This study was designed to reassess the prediction of recurrent nonfatal myocardial infarction in patients recovering from acute myocardial infarction after thrombolysis. Background. Recurrent nonfatal myocardial infarction is a strong and independent predictor of subsequent mortality. Current knowledge of risk factors for nonfatal reinfarction is still largely based on data gathered before the advent of thrombolysis. Thus, this prospective study was planned to identify harbingers of nonfatal reinfarction in the postinfarction patients of the multicenter Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI-2) trial. Methods. Predictors of nonfatal reinfarction at 6 months were analyzed by multivariate technique (Cox model) in 8,907 GISSI-2 survivors of myocardial infarction with clinical follow-up, relying on a set of prespecified variables reflecting residual ischemia, left ventricular failure or dysfunction, complex ventricular arrhythmias, comorbidity as well as demographic and historical factors. Results. The postdischarge to 6-month incidence rate of nonfetal reinfarction was 2.5%. Independent predictors of nonfatal reinfarction were cardiac ineligibility for exercise test (relative risk 2.97, 95% confidence interval [CI] 1.98 to 4.45), previous myocardial infarction (relative risk 1.70, 95% CI 1.22 to 2.36) and angina at follow-up (relative risk 1.50, 95% CI 1.10 to 2.04). On further multivariate analysis, performed in 6,580 patients with both echocardiographic and electrocardiographic monitoring data available, a history of angina emerged as an additional risk predictor (relative risk 1.58, 95% CI 1.10 to 2.25). Conclusions. The 6-month incidence of nonfatal reinfarction is rather low in survivors of myocardial infarction after thrombolysis. Cardiac ineligibility for exercise testing and a history of coronary artery disease are risk predictors. Recurrent nonfatal infarction is not predictable by qualitative variables reflecting residual ischemia, except by postdischarge angina. Prediction of nonfatal reinfarction appears less accurate than prediction of mortality, as almost 50% of reinfarctions occur in patients without any of the identified risk factors.

Original languageEnglish
Pages (from-to)608-615
Number of pages8
JournalJournal of the American College of Cardiology
Volume24
Issue number3
DOIs
Publication statusPublished - 1994

Fingerprint

Survivors
Myocardial Infarction
Databases
Confidence Intervals
Ischemia
Ventricular Dysfunction
Mortality
Incidence
Exercise Test
Proportional Hazards Models
Infarction
Comorbidity
Cardiac Arrhythmias
Coronary Artery Disease
Multivariate Analysis
Demography
Prospective Studies
Exercise

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Predictors of nonfetal reinfarction in survivors of myocardial infarction after thrombolysis. Results of the gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI-2) data base. / Volpi, Alberto; De Vita, Claudio; Franzosi, Maria Grazia; Geraci, Enrico; Maggioni, Aldo Pietro; Mauri, Francesco; Negri, Eva; Santoro, Eugenio; Tavazzi, Luigi; Tognoni, Gianni.

In: Journal of the American College of Cardiology, Vol. 24, No. 3, 1994, p. 608-615.

Research output: Contribution to journalArticle

Volpi, Alberto ; De Vita, Claudio ; Franzosi, Maria Grazia ; Geraci, Enrico ; Maggioni, Aldo Pietro ; Mauri, Francesco ; Negri, Eva ; Santoro, Eugenio ; Tavazzi, Luigi ; Tognoni, Gianni. / Predictors of nonfetal reinfarction in survivors of myocardial infarction after thrombolysis. Results of the gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI-2) data base. In: Journal of the American College of Cardiology. 1994 ; Vol. 24, No. 3. pp. 608-615.
@article{bc63603a452b476c8c187116f6c69b9e,
title = "Predictors of nonfetal reinfarction in survivors of myocardial infarction after thrombolysis. Results of the gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI-2) data base",
abstract = "Objectives. This study was designed to reassess the prediction of recurrent nonfatal myocardial infarction in patients recovering from acute myocardial infarction after thrombolysis. Background. Recurrent nonfatal myocardial infarction is a strong and independent predictor of subsequent mortality. Current knowledge of risk factors for nonfatal reinfarction is still largely based on data gathered before the advent of thrombolysis. Thus, this prospective study was planned to identify harbingers of nonfatal reinfarction in the postinfarction patients of the multicenter Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI-2) trial. Methods. Predictors of nonfatal reinfarction at 6 months were analyzed by multivariate technique (Cox model) in 8,907 GISSI-2 survivors of myocardial infarction with clinical follow-up, relying on a set of prespecified variables reflecting residual ischemia, left ventricular failure or dysfunction, complex ventricular arrhythmias, comorbidity as well as demographic and historical factors. Results. The postdischarge to 6-month incidence rate of nonfetal reinfarction was 2.5{\%}. Independent predictors of nonfatal reinfarction were cardiac ineligibility for exercise test (relative risk 2.97, 95{\%} confidence interval [CI] 1.98 to 4.45), previous myocardial infarction (relative risk 1.70, 95{\%} CI 1.22 to 2.36) and angina at follow-up (relative risk 1.50, 95{\%} CI 1.10 to 2.04). On further multivariate analysis, performed in 6,580 patients with both echocardiographic and electrocardiographic monitoring data available, a history of angina emerged as an additional risk predictor (relative risk 1.58, 95{\%} CI 1.10 to 2.25). Conclusions. The 6-month incidence of nonfatal reinfarction is rather low in survivors of myocardial infarction after thrombolysis. Cardiac ineligibility for exercise testing and a history of coronary artery disease are risk predictors. Recurrent nonfatal infarction is not predictable by qualitative variables reflecting residual ischemia, except by postdischarge angina. Prediction of nonfatal reinfarction appears less accurate than prediction of mortality, as almost 50{\%} of reinfarctions occur in patients without any of the identified risk factors.",
author = "Alberto Volpi and {De Vita}, Claudio and Franzosi, {Maria Grazia} and Enrico Geraci and Maggioni, {Aldo Pietro} and Francesco Mauri and Eva Negri and Eugenio Santoro and Luigi Tavazzi and Gianni Tognoni",
year = "1994",
doi = "10.1016/0735-1097(94)90004-3",
language = "English",
volume = "24",
pages = "608--615",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "3",

}

TY - JOUR

T1 - Predictors of nonfetal reinfarction in survivors of myocardial infarction after thrombolysis. Results of the gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI-2) data base

AU - Volpi, Alberto

AU - De Vita, Claudio

AU - Franzosi, Maria Grazia

AU - Geraci, Enrico

AU - Maggioni, Aldo Pietro

AU - Mauri, Francesco

AU - Negri, Eva

AU - Santoro, Eugenio

AU - Tavazzi, Luigi

AU - Tognoni, Gianni

PY - 1994

Y1 - 1994

N2 - Objectives. This study was designed to reassess the prediction of recurrent nonfatal myocardial infarction in patients recovering from acute myocardial infarction after thrombolysis. Background. Recurrent nonfatal myocardial infarction is a strong and independent predictor of subsequent mortality. Current knowledge of risk factors for nonfatal reinfarction is still largely based on data gathered before the advent of thrombolysis. Thus, this prospective study was planned to identify harbingers of nonfatal reinfarction in the postinfarction patients of the multicenter Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI-2) trial. Methods. Predictors of nonfatal reinfarction at 6 months were analyzed by multivariate technique (Cox model) in 8,907 GISSI-2 survivors of myocardial infarction with clinical follow-up, relying on a set of prespecified variables reflecting residual ischemia, left ventricular failure or dysfunction, complex ventricular arrhythmias, comorbidity as well as demographic and historical factors. Results. The postdischarge to 6-month incidence rate of nonfetal reinfarction was 2.5%. Independent predictors of nonfatal reinfarction were cardiac ineligibility for exercise test (relative risk 2.97, 95% confidence interval [CI] 1.98 to 4.45), previous myocardial infarction (relative risk 1.70, 95% CI 1.22 to 2.36) and angina at follow-up (relative risk 1.50, 95% CI 1.10 to 2.04). On further multivariate analysis, performed in 6,580 patients with both echocardiographic and electrocardiographic monitoring data available, a history of angina emerged as an additional risk predictor (relative risk 1.58, 95% CI 1.10 to 2.25). Conclusions. The 6-month incidence of nonfatal reinfarction is rather low in survivors of myocardial infarction after thrombolysis. Cardiac ineligibility for exercise testing and a history of coronary artery disease are risk predictors. Recurrent nonfatal infarction is not predictable by qualitative variables reflecting residual ischemia, except by postdischarge angina. Prediction of nonfatal reinfarction appears less accurate than prediction of mortality, as almost 50% of reinfarctions occur in patients without any of the identified risk factors.

AB - Objectives. This study was designed to reassess the prediction of recurrent nonfatal myocardial infarction in patients recovering from acute myocardial infarction after thrombolysis. Background. Recurrent nonfatal myocardial infarction is a strong and independent predictor of subsequent mortality. Current knowledge of risk factors for nonfatal reinfarction is still largely based on data gathered before the advent of thrombolysis. Thus, this prospective study was planned to identify harbingers of nonfatal reinfarction in the postinfarction patients of the multicenter Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI-2) trial. Methods. Predictors of nonfatal reinfarction at 6 months were analyzed by multivariate technique (Cox model) in 8,907 GISSI-2 survivors of myocardial infarction with clinical follow-up, relying on a set of prespecified variables reflecting residual ischemia, left ventricular failure or dysfunction, complex ventricular arrhythmias, comorbidity as well as demographic and historical factors. Results. The postdischarge to 6-month incidence rate of nonfetal reinfarction was 2.5%. Independent predictors of nonfatal reinfarction were cardiac ineligibility for exercise test (relative risk 2.97, 95% confidence interval [CI] 1.98 to 4.45), previous myocardial infarction (relative risk 1.70, 95% CI 1.22 to 2.36) and angina at follow-up (relative risk 1.50, 95% CI 1.10 to 2.04). On further multivariate analysis, performed in 6,580 patients with both echocardiographic and electrocardiographic monitoring data available, a history of angina emerged as an additional risk predictor (relative risk 1.58, 95% CI 1.10 to 2.25). Conclusions. The 6-month incidence of nonfatal reinfarction is rather low in survivors of myocardial infarction after thrombolysis. Cardiac ineligibility for exercise testing and a history of coronary artery disease are risk predictors. Recurrent nonfatal infarction is not predictable by qualitative variables reflecting residual ischemia, except by postdischarge angina. Prediction of nonfatal reinfarction appears less accurate than prediction of mortality, as almost 50% of reinfarctions occur in patients without any of the identified risk factors.

UR - http://www.scopus.com/inward/record.url?scp=0028040572&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028040572&partnerID=8YFLogxK

U2 - 10.1016/0735-1097(94)90004-3

DO - 10.1016/0735-1097(94)90004-3

M3 - Article

C2 - 8077528

AN - SCOPUS:0028040572

VL - 24

SP - 608

EP - 615

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 3

ER -