CARDIOVASCULAR THERAPY AND PREVENTION · Feb 8, 2026
Сomorbidities, risk factors and causes of death in patients with myocardial infarction of different prescription, based on follow-up after hospitalization at a multidisciplinary center
By Lukyanov ММ, Gomova TA, Шепель РН et al.
Aim. To analyze multimorbidity, risk factors for death, its incidence, and causes, based on long-term follow-up after hospitalization at a multidisciplinary center for acute myocardial infarction (MI) or other pathologies associated with old myocardial infarction. Material and methods. The SOFIT registry included 855 patients treated for acute MI and 1341 patients treated for other pathologies associated with old MI (age (M±SD) — 64,1±12,1 and 65,8±10,9 years; men — 65,6% and 69,7%). The median [interquartile range] follow-up duration was 2,6 [2,2; 2,9] years. Results. Multimorbidity in the comparison groups was recorded in 97,1 and 94,8% of cases (p=0,01), while cardiovascular multimorbidity — in 95,4 and 86,1% (p<0,001). In patients followed up after hospitalization for acute MI, 175 (20,5%) died, while in the group with MI prior to hospitalization — 311 (23,2%) (p=0,13). Cardiovascular diseases were the cause of death in 54,9 and 47,3% (p=0,13). In both groups, the risk of all-cause death was associated with age (hazard ratio (HR)=1,049; p<0,001 and HR=1,023; p=0,002), while in those observed after acute MI it was higher with a history of MI and hospitalization due to coronavirus disease 2019 (COVID-19) before the reference hospitalization (HR=1,623; p=0,014 and HR=2,02; p=0,002); in the group with a long-term MI — in the presence of chronic obstructive pulmonary disease (HR=2,013; p=0,006), but it was 47,2% lower when prescribing a combination of a renin-angiotensin system inhibitor, a β-blocker, an antithrombotic agents, and a statin (HR=0,528; p<0,001). The risk of cardiovascular death was higher with ≥2 prior MI as follows: by 90,2% (p=0,007) and 113% (p=0,006), but lower with quadruple pharmacotherapy (HR=0,56; p=0,048 and HR=0,637; p=0,034); in individuals with a long-term MI — also with a history of cerebrovascular accident (HR=1,613; p=0,026) and chronic obstructive pulmonary disease (HR=2,128; p=0,037). Conclusion. Patients after myocardial infarction (MI), regardless of its duration, are characterized by a high death risk due to comorbid pathology, which is significantly reduced by appropriate combination cardiovascular pharmacotherapy.