Skip to main content
Top
Published in: BMC Cardiovascular Disorders 1/2010

Open Access 01-12-2010 | Research article

The dynamics of mortality in follow-up time after an acute myocardial infarction, lower extremity arterial disease and ischemic stroke

Authors: Ilonca Vaartjes, Ineke van Dis, Diederick E Grobbee, Michiel L Bots

Published in: BMC Cardiovascular Disorders | Issue 1/2010

Login to get access

Abstract

Background

Most studies providing data on survival in patients with atherosclerosis only address a single disease site: heart, brain or legs. Therefore, our objective was to determine risk of death after first hospital admission for atherosclerotic disease located at different sites.

Methods

A nationwide cohort of patients hospitalized for the first time for acute myocardial infarction (AMI), peripheral arterial disease of the lower extremities (PAD) or ischemic stroke was identified through linkage of national registers. The mortality rate in AMI patients was compared to mortality rate in ischemic stroke and PAD patients by estimating relative risks (with 95%CI). Cox's proportional hazard models were used to estimate sex differences in risk of death.

Results

Case fatality was high for ischemic stroke patients (men:21.0%, women:23.8%) and AMI patients (men:12.7%, women:20.9%) though low for PAD patients (men:2.4%, women:3.5%). The five-year risk of death was similar for male AMI compared to PAD patients (men: RR1.04; 95%CI 0.98-1.11). The risk of death for ischemic stroke patients remained the highest though the differences with AMI and PAD patients attenuated.

Conclusions

The dynamics of mortality over follow-up time clearly differ between atherosclerotic diseases, located at different vascular beds. The risk of death increases considerably over follow-up time for PAD patients, and 5 years after first hospital admission the differences in risks of death between AMI- and PAD patients and between AMI- and ischemic stroke patients have largely attenuated. Clinicians should be aware of these dynamics of mortality over follow-up time to provide optimal secondary prevention treatment.
Appendix
Available only for authorised users
Literature
1.
go back to reference Kannel WB: Overview of atherosclerosis. Clin Ther. 1998, 20 (Suppl B): B2-17. 10.1016/S0149-2918(98)80027-1.CrossRefPubMed Kannel WB: Overview of atherosclerosis. Clin Ther. 1998, 20 (Suppl B): B2-17. 10.1016/S0149-2918(98)80027-1.CrossRefPubMed
2.
go back to reference Bray F, Guilloux A, Sankila R, Parkin DM: Practical implications of imposing a new world standard population. Cancer Causes Control. 2002, 13: 175-182. 10.1023/A:1014344519276.CrossRefPubMed Bray F, Guilloux A, Sankila R, Parkin DM: Practical implications of imposing a new world standard population. Cancer Causes Control. 2002, 13: 175-182. 10.1023/A:1014344519276.CrossRefPubMed
3.
go back to reference Thorvaldsen P, Asplund K, Kuulasmaa K, Rajakangas AM, Schroll M: Stroke incidence, case fatality, and mortality in the WHO MONICA project. World Health Organization Monitoring Trends and Determinants in Cardiovascular Disease. Stroke. 1995, 26: 361-367.CrossRefPubMed Thorvaldsen P, Asplund K, Kuulasmaa K, Rajakangas AM, Schroll M: Stroke incidence, case fatality, and mortality in the WHO MONICA project. World Health Organization Monitoring Trends and Determinants in Cardiovascular Disease. Stroke. 1995, 26: 361-367.CrossRefPubMed
4.
go back to reference Salonen R, Salonen JT: Progression of carotid atherosclerosis and its determinants: a population-based ultrasonography study. Atherosclerosis. 1990, 81: 33-40. 10.1016/0021-9150(90)90056-O.CrossRefPubMed Salonen R, Salonen JT: Progression of carotid atherosclerosis and its determinants: a population-based ultrasonography study. Atherosclerosis. 1990, 81: 33-40. 10.1016/0021-9150(90)90056-O.CrossRefPubMed
5.
go back to reference Witteman JC, Grobbee DE, Valkenburg HA, van Hemert AM, Stijnen T, Hofman A: Cigarette smoking and the development and progression of aortic atherosclerosis. A 9-year population-based follow-up study in women. Circulation. 1993, 88: 2156-2162.CrossRefPubMed Witteman JC, Grobbee DE, Valkenburg HA, van Hemert AM, Stijnen T, Hofman A: Cigarette smoking and the development and progression of aortic atherosclerosis. A 9-year population-based follow-up study in women. Circulation. 1993, 88: 2156-2162.CrossRefPubMed
6.
go back to reference van der Meer, Smith RJA: Stroke patients in the general practice. [In Dutch]. Huisarts Wet. 1990, 33: 141-144. van der Meer, Smith RJA: Stroke patients in the general practice. [In Dutch]. Huisarts Wet. 1990, 33: 141-144.
7.
go back to reference Vaartjes I, de Borst GJ, Reitsma JB, de Bruin A, Moll FL, Grobbee DE, Bots ML: Long-term survival after initial hospital admission for peripheral arterial disease in the lower extremities. BMC Cardiovasc Disord. 2009, 9: 43-10.1186/1471-2261-9-43.CrossRefPubMedPubMedCentral Vaartjes I, de Borst GJ, Reitsma JB, de Bruin A, Moll FL, Grobbee DE, Bots ML: Long-term survival after initial hospital admission for peripheral arterial disease in the lower extremities. BMC Cardiovasc Disord. 2009, 9: 43-10.1186/1471-2261-9-43.CrossRefPubMedPubMedCentral
8.
go back to reference Caro J, Migliaccio-Walle K, Ishak KJ, Proskorovsky I: The morbidity and mortality following a diagnosis of peripheral arterial disease: long-term follow-up of a large database. BMC Cardiovasc Disord. 2005, 5: 14-10.1186/1471-2261-5-14.CrossRefPubMedPubMedCentral Caro J, Migliaccio-Walle K, Ishak KJ, Proskorovsky I: The morbidity and mortality following a diagnosis of peripheral arterial disease: long-term follow-up of a large database. BMC Cardiovasc Disord. 2005, 5: 14-10.1186/1471-2261-5-14.CrossRefPubMedPubMedCentral
9.
go back to reference Koek HL, de Bruin A, Gast F, Gevers E, Kardaun JW, Reitsma JB, Grobbee DE, Bots ML: Short- and long-term prognosis after acute myocardial infarction in men versus women. Am J Cardiol. 2006, 98: 993-999. 10.1016/j.amjcard.2006.05.016.CrossRefPubMed Koek HL, de Bruin A, Gast F, Gevers E, Kardaun JW, Reitsma JB, Grobbee DE, Bots ML: Short- and long-term prognosis after acute myocardial infarction in men versus women. Am J Cardiol. 2006, 98: 993-999. 10.1016/j.amjcard.2006.05.016.CrossRefPubMed
10.
go back to reference Vaartjes I, Reitsma JB, de Bruin A, Berger-van Sijl M, Bos MJ, Breteler MM, Grobbee DE, Bots ML: Nationwide incidence of first stroke and TIA in the Netherlands. Eur J Neurol. 2008, 15: 1315-1323. 10.1111/j.1468-1331.2008.02309.x.CrossRefPubMed Vaartjes I, Reitsma JB, de Bruin A, Berger-van Sijl M, Bos MJ, Breteler MM, Grobbee DE, Bots ML: Nationwide incidence of first stroke and TIA in the Netherlands. Eur J Neurol. 2008, 15: 1315-1323. 10.1111/j.1468-1331.2008.02309.x.CrossRefPubMed
11.
go back to reference Hirsch AT, Haskal ZJ, Hertzer NR, Bakal CW, Creager MA, Halperin JL, Hiratzka LF, Murphy WR, Olin JW, Puschett JB, Rosenfield KA, Sacks D, Stanley JC, Taylor LM, White CJ, White J, White RA, Antman EM, Smith SC, Adams CD, Anderson JL, Faxon DP, Fuster V, Gibbons RJ, Hunt SA, Jacobs AK, Nishimura R, Omata JP, Page RL, Riegel B: ACC/AHA 2005 Practice Guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation. Circulation. 2006, 113: e463-e654. 10.1161/CIRCULATIONAHA.106.174526.CrossRefPubMed Hirsch AT, Haskal ZJ, Hertzer NR, Bakal CW, Creager MA, Halperin JL, Hiratzka LF, Murphy WR, Olin JW, Puschett JB, Rosenfield KA, Sacks D, Stanley JC, Taylor LM, White CJ, White J, White RA, Antman EM, Smith SC, Adams CD, Anderson JL, Faxon DP, Fuster V, Gibbons RJ, Hunt SA, Jacobs AK, Nishimura R, Omata JP, Page RL, Riegel B: ACC/AHA 2005 Practice Guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation. Circulation. 2006, 113: e463-e654. 10.1161/CIRCULATIONAHA.106.174526.CrossRefPubMed
12.
go back to reference Koek HL, de Bruin A, Gast F, Gevers E, Kardaun JW, Reitsma JB, Grobbee DE, Bots ML: Short- and long-term prognosis after acute myocardial infarction in men versus women. Am J Cardiol. 2006, 98: 993-999. 10.1016/j.amjcard.2006.05.016.CrossRefPubMed Koek HL, de Bruin A, Gast F, Gevers E, Kardaun JW, Reitsma JB, Grobbee DE, Bots ML: Short- and long-term prognosis after acute myocardial infarction in men versus women. Am J Cardiol. 2006, 98: 993-999. 10.1016/j.amjcard.2006.05.016.CrossRefPubMed
13.
go back to reference Bray F, Guilloux A, Sankila R, Parkin DM: Practical implications of imposing a new world standard population. Cancer Causes Control. 2002, 13: 175-182. 10.1023/A:1014344519276.CrossRefPubMed Bray F, Guilloux A, Sankila R, Parkin DM: Practical implications of imposing a new world standard population. Cancer Causes Control. 2002, 13: 175-182. 10.1023/A:1014344519276.CrossRefPubMed
14.
go back to reference Reitsma JB, Kardaun JW, Gevers E, de Bruin A, van der Wal J, Bonsel GJ: [Possibilities for anonymous follow-up studies of patients in Dutch national medical registrations using the Municipal Population Register: a pilot study]. Ned Tijdschr Geneeskd. 2003, 147: 2286-2290.PubMed Reitsma JB, Kardaun JW, Gevers E, de Bruin A, van der Wal J, Bonsel GJ: [Possibilities for anonymous follow-up studies of patients in Dutch national medical registrations using the Municipal Population Register: a pilot study]. Ned Tijdschr Geneeskd. 2003, 147: 2286-2290.PubMed
15.
go back to reference Espinola-Klein C, Rupprecht HJ, Blankenberg S, Bickel C, Peth S, Kopp H, Victor A, Hafner G, Meyer J: [Manifestations of atherosclerosis in various vascular regions. Similarities and differences regarding epidemiology, etiology and prognosis]. Med Klin (Munich). 2002, 97: 221-228. 10.1007/s00063-002-1144-x.CrossRef Espinola-Klein C, Rupprecht HJ, Blankenberg S, Bickel C, Peth S, Kopp H, Victor A, Hafner G, Meyer J: [Manifestations of atherosclerosis in various vascular regions. Similarities and differences regarding epidemiology, etiology and prognosis]. Med Klin (Munich). 2002, 97: 221-228. 10.1007/s00063-002-1144-x.CrossRef
16.
go back to reference Aboyans V, Lacroix P, Criqui MH: Large and small vessels atherosclerosis: similarities and differences. Prog Cardiovasc Dis. 2007, 50: 112-125. 10.1016/j.pcad.2007.04.001.CrossRefPubMed Aboyans V, Lacroix P, Criqui MH: Large and small vessels atherosclerosis: similarities and differences. Prog Cardiovasc Dis. 2007, 50: 112-125. 10.1016/j.pcad.2007.04.001.CrossRefPubMed
17.
go back to reference Criqui MH, Ninomiya JK, Wingard DL, Ji M, Fronek A: Progression of peripheral arterial disease predicts cardiovascular disease morbidity and mortality. J Am Coll Cardiol. 2008, 52: 1736-1742. 10.1016/j.jacc.2008.07.060.CrossRefPubMedPubMedCentral Criqui MH, Ninomiya JK, Wingard DL, Ji M, Fronek A: Progression of peripheral arterial disease predicts cardiovascular disease morbidity and mortality. J Am Coll Cardiol. 2008, 52: 1736-1742. 10.1016/j.jacc.2008.07.060.CrossRefPubMedPubMedCentral
18.
go back to reference Cacoub PP, Bhatt DL, Steg PG, Topol EJ, Creager MA: Patients with peripheral arterial disease in the CHARISMA trial. Eur Heart J. 2009, 30: 192-201. 10.1093/eurheartj/ehn534.CrossRefPubMed Cacoub PP, Bhatt DL, Steg PG, Topol EJ, Creager MA: Patients with peripheral arterial disease in the CHARISMA trial. Eur Heart J. 2009, 30: 192-201. 10.1093/eurheartj/ehn534.CrossRefPubMed
19.
go back to reference Watson K, Watson BD, Pater KS: Peripheral arterial disease: a review of disease awareness and management. Am J Geriatr Pharmacother. 2006, 4: 365-379. 10.1016/j.amjopharm.2006.12.006.CrossRefPubMed Watson K, Watson BD, Pater KS: Peripheral arterial disease: a review of disease awareness and management. Am J Geriatr Pharmacother. 2006, 4: 365-379. 10.1016/j.amjopharm.2006.12.006.CrossRefPubMed
20.
go back to reference Hultgren R, Olofsson P, Wahlberg E: Gender differences in patients treated for critical limb ischemia. Eur J Vasc Endovasc Surg. 2005, 29: 295-300. 10.1016/j.ejvs.2004.12.010.CrossRefPubMed Hultgren R, Olofsson P, Wahlberg E: Gender differences in patients treated for critical limb ischemia. Eur J Vasc Endovasc Surg. 2005, 29: 295-300. 10.1016/j.ejvs.2004.12.010.CrossRefPubMed
21.
go back to reference van Wijk I, Kappelle LJ, van Gijn J, Koudstaal PJ, Franke CL, Vermeulen M, Gorter JW, Algra A: Long-term survival and vascular event risk after transient ischaemic attack or minor ischaemic stroke: a cohort study. Lancet. 2005, 365: 2098-2104. 10.1016/S0140-6736(05)66734-7.CrossRefPubMed van Wijk I, Kappelle LJ, van Gijn J, Koudstaal PJ, Franke CL, Vermeulen M, Gorter JW, Algra A: Long-term survival and vascular event risk after transient ischaemic attack or minor ischaemic stroke: a cohort study. Lancet. 2005, 365: 2098-2104. 10.1016/S0140-6736(05)66734-7.CrossRefPubMed
22.
go back to reference Bonarjee VV, Rosengren A, Snapinn SM, James MK, Dickstein K: Sex-based short- and long-term survival in patients following complicated myocardial infarction. Eur Heart J. 2006, 27: 2177-2183. 10.1093/eurheartj/ehl160.CrossRefPubMed Bonarjee VV, Rosengren A, Snapinn SM, James MK, Dickstein K: Sex-based short- and long-term survival in patients following complicated myocardial infarction. Eur Heart J. 2006, 27: 2177-2183. 10.1093/eurheartj/ehl160.CrossRefPubMed
23.
go back to reference Giskes K, Kunst AE, Benach J, Borrell C, Costa G, Dahl E, Dalstra JA, Federico B, Helmert U, Judge K, et al: Trends in smoking behaviour between 1985 and 2000 in nine European countries by education. J Epidemiol Community Health. 2005, 59: 395-401. 10.1136/jech.2004.025684.CrossRefPubMedPubMedCentral Giskes K, Kunst AE, Benach J, Borrell C, Costa G, Dahl E, Dalstra JA, Federico B, Helmert U, Judge K, et al: Trends in smoking behaviour between 1985 and 2000 in nine European countries by education. J Epidemiol Community Health. 2005, 59: 395-401. 10.1136/jech.2004.025684.CrossRefPubMedPubMedCentral
24.
go back to reference Braunstein JB, Cheng A, Fakhry C, Nass CM, Vigilance C, Blumenthal RS: ABCs of cardiovascular disease risk management. Cardiol Rev. 2001, 9: 96-105. 10.1097/00045415-200103000-00008.CrossRefPubMed Braunstein JB, Cheng A, Fakhry C, Nass CM, Vigilance C, Blumenthal RS: ABCs of cardiovascular disease risk management. Cardiol Rev. 2001, 9: 96-105. 10.1097/00045415-200103000-00008.CrossRefPubMed
25.
go back to reference Mackenbach JP, van Duyne WM, Kelson MC: Certification and coding of two underlying causes of death in The Netherlands and other countries of the European Community. J Epidemiol Community Health. 1987, 41: 156-160. 10.1136/jech.41.2.156.CrossRefPubMedPubMedCentral Mackenbach JP, van Duyne WM, Kelson MC: Certification and coding of two underlying causes of death in The Netherlands and other countries of the European Community. J Epidemiol Community Health. 1987, 41: 156-160. 10.1136/jech.41.2.156.CrossRefPubMedPubMedCentral
26.
go back to reference Paas GRA, Veenhuizen KCW: Research on the validity of the LMR. [In Dutch]. 2002, Utrecht Paas GRA, Veenhuizen KCW: Research on the validity of the LMR. [In Dutch]. 2002, Utrecht
27.
go back to reference De Bruin A, Kardaun JWPF, Gast A, de Bruin E, van Sijl M, Verweij G: Record linkage of hospital discharge register with population register: experiences at Statistics Netherlands. Statistical Journal of the United Nations Economic Commission for Europe. 2004, 21: 23-32. De Bruin A, Kardaun JWPF, Gast A, de Bruin E, van Sijl M, Verweij G: Record linkage of hospital discharge register with population register: experiences at Statistics Netherlands. Statistical Journal of the United Nations Economic Commission for Europe. 2004, 21: 23-32.
28.
go back to reference Benesch C, Witter DM, Wilder AL, Duncan PW, Samsa GP, Matchar DB: Inaccuracy of the International Classification of Diseases (ICD-9-CM) in identifying the diagnosis of ischemic cerebrovascular disease. Neurology. 1997, 49: 660-664.CrossRefPubMed Benesch C, Witter DM, Wilder AL, Duncan PW, Samsa GP, Matchar DB: Inaccuracy of the International Classification of Diseases (ICD-9-CM) in identifying the diagnosis of ischemic cerebrovascular disease. Neurology. 1997, 49: 660-664.CrossRefPubMed
29.
go back to reference Ellekjaer H, Holmen J, Kruger O, Terent A: Identification of incident stroke in Norway: hospital discharge data compared with a population-based stroke register. Stroke. 1999, 30: 56-60.CrossRefPubMed Ellekjaer H, Holmen J, Kruger O, Terent A: Identification of incident stroke in Norway: hospital discharge data compared with a population-based stroke register. Stroke. 1999, 30: 56-60.CrossRefPubMed
30.
go back to reference Merry AH, Boer JM, Schouten LJ, Feskens EJ, Verschuren WM, Gorgels AP, van den Brandt PA: Validity of coronary heart diseases and heart failure based on hospital discharge and mortality data in the Netherlands using the cardiovascular registry Maastricht cohort study. Eur J Epidemiol. 2009, 24: 237-247. 10.1007/s10654-009-9335-x.CrossRefPubMed Merry AH, Boer JM, Schouten LJ, Feskens EJ, Verschuren WM, Gorgels AP, van den Brandt PA: Validity of coronary heart diseases and heart failure based on hospital discharge and mortality data in the Netherlands using the cardiovascular registry Maastricht cohort study. Eur J Epidemiol. 2009, 24: 237-247. 10.1007/s10654-009-9335-x.CrossRefPubMed
31.
go back to reference Bonarjee VV, Rosengren A, Snapinn SM, James MK, Dickstein K: Sex-based short- and long-term survival in patients following complicated myocardial infarction. Eur Heart J. 2006, 27: 2177-2183. 10.1093/eurheartj/ehl160.CrossRefPubMed Bonarjee VV, Rosengren A, Snapinn SM, James MK, Dickstein K: Sex-based short- and long-term survival in patients following complicated myocardial infarction. Eur Heart J. 2006, 27: 2177-2183. 10.1093/eurheartj/ehl160.CrossRefPubMed
32.
go back to reference Burn J, Dennis M, Bamford J, Sandercock P, Wade D, Warlow C: Long-term risk of recurrent stroke after a first-ever stroke. The Oxfordshire Community Stroke Project. Stroke. 1994, 25: 333-337.CrossRefPubMed Burn J, Dennis M, Bamford J, Sandercock P, Wade D, Warlow C: Long-term risk of recurrent stroke after a first-ever stroke. The Oxfordshire Community Stroke Project. Stroke. 1994, 25: 333-337.CrossRefPubMed
33.
go back to reference Hata J, Tanizaki Y, Kiyohara Y, Kato I, Kubo M, Tanaka K, Okubo K, Nakamura H, Oishi Y, Ibayashi S, Iida M: Ten year recurrence after first ever stroke in a Japanese community: the Hisayama study. J Neurol Neurosurg Psychiatry. 2005, 76: 368-372. 10.1136/jnnp.2004.038166.CrossRefPubMedPubMedCentral Hata J, Tanizaki Y, Kiyohara Y, Kato I, Kubo M, Tanaka K, Okubo K, Nakamura H, Oishi Y, Ibayashi S, Iida M: Ten year recurrence after first ever stroke in a Japanese community: the Hisayama study. J Neurol Neurosurg Psychiatry. 2005, 76: 368-372. 10.1136/jnnp.2004.038166.CrossRefPubMedPubMedCentral
Metadata
Title
The dynamics of mortality in follow-up time after an acute myocardial infarction, lower extremity arterial disease and ischemic stroke
Authors
Ilonca Vaartjes
Ineke van Dis
Diederick E Grobbee
Michiel L Bots
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2010
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/1471-2261-10-57

Other articles of this Issue 1/2010

BMC Cardiovascular Disorders 1/2010 Go to the issue