AI Article Synopsis
- Liver cirrhosis may lead to fewer coronary and cerebrovascular events in patients experiencing acute myocardial infarction (AMI), but these individuals face higher overall mortality rates due to complications related to liver disease and bleeding.
- A study analyzed data from 3217 cirrhotic and 6434 non-cirrhotic patients from Taiwan between 2001 and 2013, indicating that cirrhotic patients had lower incidences of recurrent myocardial infarction and major cardiac events compared to their non-cirrhotic counterparts.
- Despite having fewer cardiac events, cirrhotic patients with AMI showed significantly higher rates of liver-related complications and all-cause mortality, emphasizing the need for tailored medical management in these patients.
Article Abstract
Liver cirrhotic predisposes patients to coagulopathy and bleeding. Little is known about outcomes of acute myocardial infarction (AMI) in cirrhotic patients.Data from Taiwan National Health Insurance Research Database during 2001 to 2013 were retrieved for patients admitted with cirrhosis and AMI. We excluded patients with missing information, <20 years old, previous AMI, previous coronary intervention, and liver transplant. Patients were separated into cirrhotic and non-cirrhotic. Primary outcomes included all-cause mortality, recurrent myocardial infarction (MI), major cardiac and cerebrovascular events (MACCE: recurrent MI, revascularization, ischemic stroke, and heart failure), and liver outcomes (hepatic encephalopathy, ascites tapping, spontaneous peritonitis, and esophageal varices bleeding).A total of 3217 cirrhotic patients and 6434 non-cirrhotic patients were analyzed, with a mean follow up of 2.8 ± 3.3 years. In cirrhotic patients with AMI, subsequent coronary and cerebrovascular events were lower in comparison to non-cirrhotic patients, with higher all-cause mortality observed from adverse liver related outcomes and bleeding. There were significantly lower cumulative incidence of both recurrent MI and MACCE in cirrhotic patients with AMI compared with non-cirrhotic patients with AMI (hazard ratio [HR] 0.82, confidence interval [CI] 0.71-0.94, P = .006 and HR 0.86, 95% CI 0.79-0.92, P < .001, respectively). There was significantly higher cumulative incidence of liver related outcome in cirrhotic patients with AMI compared with non-cirrhotic patients with AMI (HR 2.27, 95% CI 2.06-2.51, P < .001). And there was significantly higher all-cause mortality in cirrhotic patients with AMI compared with non-cirrhotic patients with AMI (HR 1.30, 95% CI 1.23-1.38, P < .001).In cirrhotic cohort with AMI, a decreased in coronary and cerebrovascular events were observed. However, these patients also had higher all-cause mortality due to adverse liver outcomes and bleeding.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7220517 | PMC |
| http://dx.doi.org/10.1097/MD.0000000000019575 | DOI Listing |
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