Prognosis

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Behandeling acuut coronair syndroom in een urgente situatie (in afwachting van hospitalisatie)Published by: Werkgroep Ontwikkeling Richtlijnen Eerste Lijn (Worel)Last published: 2022La prise en charge du syndrome coronarien aigu (SCA) en situation d'urgence (en attente d'hospilatisation)Published by: Groupe de Travail Développement de recommmandations de première ligneLast published: 2022

Prognosis for patients with STEMI varies depending on time to presentation after onset of chest pain and time to treatment after presentation. In-hospital mortality from STEMI is around 9%.[234][235] Survival rates have improved significantly over the last 20 years but mortality remains substantial, particularly when complicated by cardiogenic shock. Major bleeding as defined by the Bleeding Academic Research Consortium (BARC) or the Thrombolysis in Myocardial Infarction (TIMI) bleeding score is associated with worse 1-year mortality.[236]

Patients with elevated troponin levels have a worse prognosis than those with normal troponin levels.[237][238]​​ Prognosis is improved by early reperfusion, adherence to appropriate medical therapy, and risk factor modification. Participation in cardiac rehabilitation reduces all-cause mortality and readmissions for cardiac reasons.[239]​ Non-fatal health outcomes (including development of heart failure, atrial fibrillation, cerebrovascular disease, peripheral arterial disease, severe bleeding, renal failure, diabetes mellitus, dementia, depression and cancer) and all-cause mortality are higher in patients who have had an MI.[240]​​

Adherence to evidence-based medicine has been shown to have better patient outcomes.[241][242]​​ Specific risk models to predict mortality following MI in older adults have been developed, including variables such as hearing impairment, mobility impairment, weight loss, and patient-reported health status.[243]​​

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