Six-year survival study after myocardial infarction: The EOLE prospective cohort study. Long-term survival after MI - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Thérapie Année : 2019

Six-year survival study after myocardial infarction: The EOLE prospective cohort study. Long-term survival after MI

C. Droz-Perroteau
  • Fonction : Auteur
P. Blin
  • Fonction : Auteur
C. Dureau-Pournin
  • Fonction : Auteur
D. Thomas
  • Fonction : Auteur
N. Danchin
  • Fonction : Auteur
J. Tricoire
  • Fonction : Auteur
F. Paillard
  • Fonction : Auteur
S. Hercberg
  • Fonction : Auteur
L. Guize
  • Fonction : Auteur
E. Guiard
  • Fonction : Auteur
H. Maizi
  • Fonction : Auteur
M. A. Bernard
  • Fonction : Auteur

Résumé

BACKGROUND: Studies of survival after myocardial infarction (MI) are often based on intention to treat analyses of controlled trials. OBJECTIVES: Describe long-term survival after MI in France. METHODS: Six-year cohort study of patients recruited within 3 months after MI. Primary outcome was all-cause death. Vital status was verified in the national death registry. Analysis used Cox models with time-dependent variables and propensity scores. RESULTS: Five thousand five hundred and twenty-seven (5527) subjects were included, 62.1+/-13 years old, 77.6% male, 9.6% smokers, 16.7% diabetic, 13.3% with previous MI. Up to 99% of patients were initially prescribed secondary prevention drugs (aspirin and/or other antiplatelet agents, beta-blockers, statins or other lipid-lowering agents, angiotensin converting enzyme inhibitors or angiotensin receptor blockers); 73% had all four classes. Overall 6-year mortality was 13.1% [95% confidence interval 12.3 to 14.0%], 2.34 per hundred patient-years (% PY); 49% returned all or all but one of the possible questionnaires (compliant [C]), 50.8% did not (non-compliant [NC]). The main predictors for death were non-compliance with study protocol (death rates NC 2.98% PY, C 1.69%PY, hazard ratio (HR) 3.13 [2.63-3.57]); increasing age at inclusion (HR up to 15.7 [10.7-23.2] for age >/=80); diabetes (1.39 [1.17-1.65]); smoking at inclusion (1.76 [1.27-2.44]), previous MI (1.46 [1.22-1.75]). Beta-blockers (0.79 [0.64-0.96]), statins (0.68 [0.51-0.90]), and enrolment in physical rehabilitation programs (0.74 [0.62-0.89]) were associated with a lower death rate. CONCLUSION: Association of mortality with non-compliance to study protocol probably indicates general non-compliance with prevention. Analyses of treatment effects were hindered by paucity of events and of unexposed patients.

Mots clés

Fichier principal
Vignette du fichier
S0040595719300320.pdf (374.8 Ko) Télécharger le fichier
Origine : Fichiers produits par l'(les) auteur(s)

Dates et versions

hal-03211507 , version 1 (20-12-2021)

Licence

Paternité - Pas d'utilisation commerciale

Identifiants

Citer

C. Droz-Perroteau, P. Blin, C. Dureau-Pournin, D. Thomas, N. Danchin, et al.. Six-year survival study after myocardial infarction: The EOLE prospective cohort study. Long-term survival after MI. Thérapie, 2019, 74 (4), pp.459-468. ⟨10.1016/j.therap.2019.02.001⟩. ⟨hal-03211507⟩

Collections

EOLE U1219
40 Consultations
27 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More