Acute Myocardial Infarction: Managing a life-changing event and additional risks

An acute myocardial infarction (MI), commonly known as a heart attack, is a traumatic experience for any person and their loved ones. Many of us may be familiar with the anxiety and uncertainty felt in that moment – and those who do survive an acute MI often live with long-lasting consequences or need to follow strict rehabilitation programmes, meaning they are not automatically able to return to the life they once knew. They remain at high risk for a second event, or even interrelated diseases.1

Up to one in five patients who have an acute MI go on to have a subsequent cardiovascular (CV) event (acute MI, stroke or CV death) within the first year.2 There is also a clear established link between acute MI and heart failure (HF). Many patients who experience acute MI will develop HF,3 a particularly concerning statistic as severity of HF following an acute coronary event increases the risk for hospital readmissions and is the strongest predictor of in-hospital mortality4,5

It is important to proactively address this increased CV risk, to offer these people a longer and higher-quality life and try to reduce hospital return rates. Guideline recommended treatment methods coupled with regular check-ups and a healthy lifestyle are the first step.6, 7

Lifestyle changes and holistic cardiac rehabilitation programmes that promote positive behaviour change can help.8 But are these enough?

Though the standard of care for patients with acute MI has improved considerably over the years, it is increasingly apparent that the prognosis has remained unchanged in recent years9 – indicating that new approaches are needed to further improve outcomes in acute MI and address a range of associated risk factors such as HF, diabetes and chronic kidney disease.4,5,9

At AstraZeneca, we are following the science and working with healthcare professionals to help improve outcomes for people living with heart failure and interrelated cardiovascular diseases.

 

References
1. World Health Organization. Cardiovascular Disease [cited 2020 Jun 18]. Available from: URL: https://www.who.int/cardiovascular_diseases/priorities/secondary_prevention/country/en/index1.html

2. Jernberg T et al. Cardiovascular risk in post-myocardial infarction patients: Nationwide real world data demonstrate the importance of a long-term perspective. Eur Heart J 2015; 36(19):1163–70.

3. Steg PG et al. Determinants and prognostic impact of heart failure complicating acute coronary syndromes: Observations from the Global Registry of Acute Coronary Events (GRACE). Circulation 2004; 109(4):494–9.

4. Granger CB et al. Predictors of hospital mortality in the global registry of acute coronary events. Arch Intern Med 2003; 163(19):2345–53.

5. Khera R et al. Comparison of Readmission Rates After Acute Myocardial Infarction in 3 Patient Age Groups (18 to 44, 45 to 64, and ≥65 Years) in the United States. The American Journal of Cardiology 2017; 120(10):1761–7.

6. Ibanez B et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J 2018; 39(2):119–77.

7. Ponikowski P et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J 2016; 37(27):2129–200.

8. Dalal HM et al. Cardiac rehabilitation. BMJ 2015; 351:h5000.

9. European Society of Cardiology. No changes in survival after acute myocardial infarction in the last decade – new data from SWEDEHEART: ESC Congress News 2018 - Munich, Germany; 2018 [cited 2020 Jun 9]. Available from: URL: https://www.escardio.org/Congresses-&-Events/ESC-Congress/Congress-resources/Congress-news/no-changes-in-survival-after-acute-myocardial-infarction-in-the-last-decade-new-data-from-swedeheart

 

Veeva ID: Z4-23025 | Date of Preparation: July 2020