Causes of Death in Patients with Acute and Chronic Myocardial Injury

BACKGROUND:

Information about causes of death in patients with myocardial injury is limited. The purpose of this study was to explore causes of death in patients with myocardial injury.

METHODS:

In a cohort of 22,589 patients, 3,853 patients with myocardial injury were identified and categorized into: type 1 myocardial infarction, type 2 myocardial infarction, and non-ischemic acute and chronic myocardial injury. We included all 1,466/3,853 (38%) patients who died during follow-up (3.9 ± 2 years). We estimated rates and adjusted OR with 95% CI for causes of death in the four categories of myocardial injury using patients without myocardial injury 819/17,932 (4.6%) who died as reference.

RESULTS:

The study cohort included 2,285 patients. The proportion of cardiovascular deaths was higher in patients with type 1 myocardial infarction (48%), acute (43%), and chronic (45%) myocardial injury and type 2 myocardial infarction (39%) compared with patients without myocardial injury (25%). Adjusted rates for cardiovascular death were similar in patients with myocardial injury. Type 1 myocardial infarction, acute, and chronic myocardial injury was associated with a 77% (OR: 1.77, 95% CI 1.29-2.41), 40% (OR: 1.40, 95% CI: 1.07-1.84), and 36% (OR: 1.36, 95% CI: 1.05-1.76) higher risk of cardiovascular death.

CONCLUSIONS:

Patients with type 1 myocardial infarction and acute or chronic myocardial injury have similar proportions and high risks for cardiovascular death. We believe that these findings stress the need for investigating patients without known heart diseases who present with non-ischemic myocardial injury, or type 2 myocardial infarction.