Factors Associated With Mortality During the First Year Post Infarction: Survival Analysis of Patients With Acute Myocardial Infarction in Colombia

TL;DR

This study identifies factors like age, diabetes, and kidney disease that increase the risk of death in heart attack patients in Colombia within the first year.

Contribution

The study provides new insights into post-AMI mortality predictors in a Colombian population using a large prospective cohort.

Findings

The one-year mortality rate was 9.4% among 1873 patients with acute myocardial infarction.

Age, diabetes, and renal insufficiency were significant predictors of mortality.

The survival probability at one year was estimated at 88.61%.

Abstract

Introduction: Cardiovascular diseases account for over 80% of global deaths. Risk factors and social determinants influence mortality in patients post acute myocardial infarction (AMI).

Objective: To evaluate factors associated with post-AMI mortality during the one-year follow-up.

Materials and methods: The study is a prospective cohort study of adults aged 18 years and older with type 1 AMI conducted between October 2021 and January 2024. Intrahospital and outpatient information was collected. Statistical analyses included the Kaplan-Meier survival curve and Cox regression analysis. Proportional hazards and model predictive capacity were evaluated.

Results: A total of 1873 patients were included, with a 9.4% mortality rate in the first year. At one year, the estimated survival probability was 88.61% (95% CI: 86.82-90.18). Cox analysis identified several factors associated with mortality, highlighting age (HR = 1.04, 95% CI: 1.02-1.06, p = 0.001), diabetes (HR = 1.77, 95% CI: 1.09-2.87, p = 0.020), renal insufficiency (HR = 2.25, 95% CI: 1.32-3.84, p = 0.003), and type of intervention. The model evaluation showed strong predictive capacity.

Conclusions: It is essential to emphasize the importance of comprehensive management in AMI patients with risk factors such as diabetes and chronic kidney disease, as they are significant predictors of mortality during the first year post infarction.

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