Long-term follow-up of survivors of a first acute coronary syndrome: Results from the French MONICA registries from 2009 to 2017 - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue International Journal of Cardiology Année : 2023

Long-term follow-up of survivors of a first acute coronary syndrome: Results from the French MONICA registries from 2009 to 2017

Victoria Gauthier
  • Fonction : Auteur
Martin Lafrance
  • Fonction : Auteur
Maël Barthoulot
  • Fonction : Auteur
Louis Rousselet
Michèle Montaye
  • Fonction : Auteur
Jean Ferrières
  • Fonction : Auteur
Samantha Huo Yung Kai
  • Fonction : Auteur
Katia Biasch
  • Fonction : Auteur
Marie Moitry
  • Fonction : Auteur
Philippe Amouyel
  • Fonction : Auteur
Jean Dallongeville
  • Fonction : Auteur

Résumé

Aim: The objectives of the study were to characterize the long-term risk of first recurrence of acute coronary syndrome (ACS) among survivors of an incident ACS, as a function of the STEMI/NSTEMI/UA diagnosis. Methods: Men and women (aged 35–74) hospitalized between 2009 and 2016 for an incident ACS in the French MONICA registries and still alive on discharge were followed-up until December 2017. Recurrent events were defined as the first (non-fatal or fatal) ACS occurring after hospital discharge from the incident event. Results: The study comprised 15,739 incident ACSs with 63,777 patient-years of follow-up. The cumulative probability [95% confidence interval] of recurrent ACS was 6.7% [6.3–7.1%] at 1 year and 18.4% [17.4–19.5%] at 9 years. The cumulative probability of fatal recurrent ACS was 1.4% [1.2–1.5%] at 1 year and 4.3% [3.6–4.9%] at 9 years. The risk of recurrence did not depend on the type of the incident ACS after adjustment for confounding factors. The most frequent forms of recurrence were NSTEMI and UA. The presence of a major complication (OR = 1.59) and an impaired left ventricular ejection fraction (LVEF) (OR > 1.26) increased the risk of recurrence. The annual 1-year recurrence rates decreased from 7.4% in 2009 to 4.0% in 2016 (p < 0.001). Conclusion: The recurrence rate after an incident ACS remained high in France, and the risk of recurrence did not depend on the etiology of the first event. Our results emphasize the importance of targeting patients with a major complication and/or an impaired LVEF who are at a higher risk of recurrence.
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Dates et versions

hal-04006741 , version 1 (27-02-2023)

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Citer

Victoria Gauthier, Martin Lafrance, Maël Barthoulot, Louis Rousselet, Michèle Montaye, et al.. Long-term follow-up of survivors of a first acute coronary syndrome: Results from the French MONICA registries from 2009 to 2017. International Journal of Cardiology, 2023, 378, pp.138-143. ⟨10.1016/j.ijcard.2023.02.035⟩. ⟨hal-04006741⟩
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