20-YEAR FOLLOW UP OF UNSELECTED STEMI PATIENTS TREATED WITH PRIMARY PCI

Study goal:
To analyse 20 years mortality and cause of death of consecutive patients after STEMI treated with primary PCI from the single centre registry
Methods and results:
Analysis was performed by analysing  all consecutive patients that were treated for STEMI using pPCI between 1st January 2000 and 31st December 2002. With cooperation of Institute of health information and statistics, data regarding mortality and cause of death were obtained (date of censoring 30 April 2021). We have assessed the mortality and cause of death in all patients. Furthermore, we performed the analysis in young patients < 65 years without history of previous myocardial infarction (MI).
Altogether, 960 patients (male sex 71.4%, n=686) with STEMI were treated by pPCI in our centres during 3 years period (2000-2002). The mean age for men was 61.3 + 11.4 years and for women 69.8 + 11.2 years (p<0.001). Out of this study group, 402 patients (41.8%) were < 65 years without history of MI. 20 years mortality for all patients was 66% and cardiovascular mortality was 44% (representing 2/3 of cardiovacular cause of all death). In < 65 years without history of MI without history of MI, cardiovascular cause of death was present in 54.4% of all deaths with 20 years cardiovascular mortality of 24% and all-cause 20 years mortality was 44%. No difference was found in 20-year survival between men and women in patients < 65 years without history of MI (mean survival  to date of analysis in women and men was 15.4 and 16.3 years, respectively; p=0.128).
Conclusion:
This study is the longest follow-up of STEMI patients treated by primary PCI. We have shown that the cardiovascular death is the major cause of death during the very long-term follow up. The survival probability in younger population without previous history of MI is acceptable with lower rate of cardiovascular death.