Restricted loss of life expectancy in patients with acute myocardial infarction
J H Choi, W Kim, Y K Ahn, M H JeongAbstract
Background
The mortality risk of acute myocardial infarction (AMI) declines rapidly after the initial period, yet the quantitative measures of residual risk in the follow-up period remain limited.
Purpose
We aimed to assess restricted loss of life expectancy (LOLE) in patients with AMI.
Methods
We included patients from KAMIR, a nationwide AMI registry, between 2012 and 2020. The survival of 27,705 patients (mean age 64 years, 76% male) was compared with an age-, sex-, and calendar year-matched reference cohort derived from Korean population life tables. Three-year restricted LOLE was estimated using Royston-Parmar flexible parametric survival model adjusted for clinical characteristics.
Results
In overall, 3-year restricted LOLE was 23 days (95%CI = 22 – 25 days). In subgroup analyses, older age (≥75 years, 41 [37 – 46] days versus <50 years, 7 [6 –13] days), female sex (48 [44 – 52] days versus male, 15 [14 – 17] days), and lower left ventricular ejection fraction (≤40%, 135 [128 – 143] days versus ≥50%, 0 [-1 – 1] days) were associated with higher 3-year restricted LOLE. Across the study period, 3-year restricted LOLE nearly halved from 36 [33 – 42] to 16 [13 – 28] days.
Conclusions
Restricted LOLE provides intuitive, patient-centered measures of residual risk after AMI. It also demonstrated a significant improvements in patient outcomes over the study period.Central Illustration