• Yugo Yamashita, Hiroki Shiomi, Takeshi Morimoto, Hidenori Yaku, Yutaka Furukawa, Yoshihisa Nakagawa, Kenji Ando, Kazushige Kadota, Mitsuru Abe, Kazuya Nagao, Satoshi Shizuta, Koh Ono, Takeshi Kimura, and CREDO-Kyoto AMI Registry Investigators.
• From the Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan (Y.Y., H.S., H.Y., S.S., K.O., T.K.), Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan (T.M.); Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan (Y.F.); Division of Cardiology, Tenri Hospital, Tenri, Japan (Y.N.); Division of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Division of Cardiology, Kurashiki Central Hospital, Kurashiki, Japan (K.K.); Division of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan (M.A.); and Division of Cardiology, Osaka Red Cross Hospital, Osaka, Japan (K.N.).
• Circ Cardiovasc Qual. 2017 Jan 1; 10 (1).

BackgroundIn patients with ST-segment-elevation acute myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention, long-term risks for cardiac and noncardiac death beyond acute phase of STEMI have not been thoroughly evaluated yet.Methods And ResultsWe identified 3942 STEMI patients who had primary percutaneous coronary intervention within 24 hours after onset between January 2005 and December 2007 in the CREDO-Kyoto AMI registry (Coronary Revascularization Demonstrating Outcome study in Kyoto Acute Myocardial Infarction) and evaluated their short-term (within 6-month) and long-term (beyond 6-month) incidences and causes of deaths. The cumulative 5-year incidence of all-cause death in the current study population was 20.4% (cardiac death, 12.2% and noncardiac death, 9.4%, respectively). The vast majority of deaths were cardiac in origin within 6-month (cardiac death, 8.0% and noncardiac death, 0.9%), whereas noncardiac death accounted for nearly two thirds of all-cause death beyond 6-month (cardiac death, 4.6% and noncardiac death, 8.5%). In the stratified analysis according to age, the proportion of noncardiac death was similar regardless of age although the absolute mortality rate was higher with increasing age. By the multivariable Cox regression models, the independent risk factors of all-cause death were advanced age, cardiogenic shock, renal dysfunction, large infarct size, and anterior wall infarction within 6 months after STEMI, and advanced age, previous heart failure, renal dysfunction, and liver cirrhosis beyond 6 months after STEMI, respectively.ConclusionsIn STEMI patients who underwent primary percutaneous coronary intervention, the long-term risk for cardiac death was relatively low compared with that for noncardiac death, which accounted for nearly two thirds of all-cause death beyond 6 months.© 2017 American Heart Association, Inc.

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