{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T12:15:01Z","timestamp":1784031301478,"version":"3.55.0"},"reference-count":33,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:00:00Z","timestamp":1748563200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinics and Practice"],"abstract":"<jats:p>Background\/aim: The aim of this study was to determine predictors of major adverse cardiovascular events, including MACE (mortality, non-fatal recurrent infarction, non-fatal stroke, and target vessel revascularization-TVR) in stable post-STEMI patients. Method: We analyzed STEMI patients without cardiogenic shock at admission included in our STEMI Register. The patients were treated with primary PCI. The follow-up period was eight years. Results: From 1 December 2006 to 31 December 2016, a total of 3079 patients were included in the Register. In the first year, MACE was registered in 348 (11.3%) patients. The remaining patients were considered stable. They were included in further analysis. At eight years, the rates were as follows: MACE 3.9%, non-fatal recurrent infarction 2.1%, TVR 1.8%, non-fatal stroke 0.5%, and mortality 2.1%. Predictors for 8-year MACE were age &gt;60 years (60\u201369 vs. &lt;60 years HR 1.65; 70\u201379 vs. &lt;60 years HR 1.82; \u226580 vs. &lt;60 years HR 3.16), EF &lt; 50% (EF 40\u201349% HR 2.38; EF &lt; 40% HR 2.32), diabetes mellitus (HR 1.49), and 3-vessel coronary artery disease (HR 1.44). Conclusions: Four predictors identified stable post-STEMI patients who remained at a higher risk for the occurrence of MACE. Stable post-STEMI patients with one or more of these risk factors may require more aggressive secondary prevention measures or a personalized approach to improve their prognosis.<\/jats:p>","DOI":"10.3390\/clinpract15060106","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T08:07:58Z","timestamp":1748592478000},"page":"106","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Predictors of Major Adverse Cardiovascular Events in Stable Patients After ST Elevation Myocardial Infarction"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7526-1641","authenticated-orcid":false,"given":"Lidija","family":"Savic","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"},{"name":"Cardiology Intensive Care Unit & Cardiology Clinic, Emergency Hospital, University Clinical Center of Serbia, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damjan","family":"Simic","sequence":"additional","affiliation":[{"name":"Cardiology Intensive Care Unit & Cardiology Clinic, Emergency Hospital, University Clinical Center of Serbia, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9033-5995","authenticated-orcid":false,"given":"Ratko","family":"Lasica","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"},{"name":"Cardiology Intensive Care Unit & Cardiology Clinic, Emergency Hospital, University Clinical Center of Serbia, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4849-7031","authenticated-orcid":false,"given":"Gordana","family":"Krljanac","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"},{"name":"Cardiology Intensive Care Unit & Cardiology Clinic, Emergency Hospital, University Clinical Center of Serbia, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanja","family":"Stankovic","sequence":"additional","affiliation":[{"name":"Center for Medical Biochemistry, Emergency Hospital, University Clinical Center of Serbia, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor","family":"Mrdovic","sequence":"additional","affiliation":[{"name":"Cardiology Intensive Care Unit & Cardiology Clinic, Emergency Hospital, University Clinical Center of Serbia, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milika","family":"Asanin","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"},{"name":"Cardiology Intensive Care Unit & Cardiology Clinic, Emergency Hospital, University Clinical Center of Serbia, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1177\/2048872617710790","article-title":"Relative survival and excess mortality following primary percutaneous coronary intervention for ST-elevation myocardial infarction","volume":"8","author":"Brogan","year":"2019","journal-title":"Eur. Heart J. Acute Cardiovasc. Care"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1002\/clc.23116","article-title":"Predictors of all-cause mortality and ischemic events within and beyond 1 year after an acute coronary syndrome: Results from the EPICOR registry","volume":"42","author":"Rossello","year":"2019","journal-title":"Clin. Cardiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1177\/2048872617735803","article-title":"Clinical outcomes following primary percutaneous coronary intervention for ST-elevation myocardial infarction according to sex and race","volume":"8","author":"Krishnamurthy","year":"2019","journal-title":"Eur. Heart J. Acute Cardiovasc. Care"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1177\/2048872617730037","article-title":"Predictors of subsequent myocardial infarction, stroke, and death in stable post-myocardial infarction patients: A nationwide cohort study","volume":"8","author":"Chen","year":"2019","journal-title":"Eur. Heart J. Acute Cardiovasc. Care"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1016\/j.recesp.2020.08.006","article-title":"STEMI, primary percutaneous coronary intervention and recovering of life expectancy: Insights from the SurviSTEMI study","volume":"74","author":"Pascual","year":"2021","journal-title":"Rev. Esp. Cardiol. (Engl. Ed.)"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Johansson, S., Rosengren, A., Young, K., and Jennings, E. (2017). Mortality and morbidity trends after the first year in survivors of acute myocardial infarction: A systematic review. BMC Cardiovasc. Disord., 17.","DOI":"10.1186\/s12872-017-0482-9"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1093\/ehjcvp\/pvx009","article-title":"Coronary artery disease severity and long-term cardiovascular risk in patients with myocardial infarction: A Danish nationwide register-based cohort study","volume":"4","author":"Deleskog","year":"2018","journal-title":"Eur. Heart J. Cardiovasc. Pharmacother."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"C225","DOI":"10.1093\/eurheartj\/suac013","article-title":"Impact of myocardial revascularization on long-term outcomes in a nationwide cohort of first acute myocardial infarction survivors","volume":"24","author":"Rosato","year":"2022","journal-title":"Eur. Heart J. Suppl."},{"key":"ref_9","first-page":"200198","article-title":"Residual cardiovascular risk, use of standard care treatments, and achievement of treatment goals in patients with cardiovascular disease","volume":"18","author":"Siniawski","year":"2023","journal-title":"Int. J. Cardiol. Cardiovasc. Risk Prev."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.ijcard.2019.06.040","article-title":"Managed Care after Acute Myocardial Infarction (MC-AMI)\u2014A Poland\u2019s nationwide program of comprehensive post-MI care-improves prognosis in 12-month follow-up. Preliminary experience from a single high-volume center","volume":"296","author":"Wita","year":"2019","journal-title":"Int. J. Cardiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1002\/clc.23283","article-title":"Predicting risk of cardiovascular events 1 to 3 years post-myocardial infarction using a global registry","volume":"43","author":"Pocock","year":"2020","journal-title":"Clin. Cardiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e025572","DOI":"10.1161\/JAHA.122.025572","article-title":"Incidence and Predictors of Adverse Events Among Initially Stable ST-Elevation Myocardial Infarction Patients Following Primary Percutaneous Coronary Intervention","volume":"11","author":"Amon","year":"2022","journal-title":"J. Am. Heart Assoc."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"3028","DOI":"10.1093\/eurheartj\/eht356","article-title":"Cardiovascular disease in Europe: Epidemiological update","volume":"34","author":"Nichols","year":"2013","journal-title":"Eur. Heart J."},{"key":"ref_14","first-page":"1003","article-title":"STEMI in women. Life expectancy recovery after primary percutaneous coronary intervention","volume":"76","author":"Avanzas","year":"2023","journal-title":"Rev. Espanola Cardiol."},{"key":"ref_15","first-page":"200310","article-title":"The relative impact of components of high residual risk on the long-term prognosis after AMI","volume":"22","author":"Mureddu","year":"2024","journal-title":"Int. J. Cardiol. Cardiovasc. Risk Prev."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Hwang, S.Y., Kim, S.H., Uhm, I.A., Shin, J.-H., and Lim, Y.-H. (2022). Prognostic implications for patients after myocardial infarction: An integrative literature review and in-depth interviews with patients and experts. BMC Cardiovasc. Disord., 22.","DOI":"10.1186\/s12872-022-02753-z"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1093\/ehjqcco\/qcw004","article-title":"Using big data from health records from four countries to evaluate chronic disease outcomes: A study in 114 364 survivors of myocardial infarction","volume":"2","author":"Rapsomaniki","year":"2016","journal-title":"Eur. Heart J. Qual. Care Clin. Outcomes"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1093\/eurheartj\/ehl535","article-title":"Long-term outcomes of patients with acute myocardial infarction presenting to hospitals without catheterization laboratory and randomized to immediate thrombolysis or interhospital transport for primary percutaneous coronary intervention. Five years\u2019 follow-up of the PRAGUE-2 trial","volume":"28","author":"Widimsky","year":"2007","journal-title":"Eur. Heart J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1177\/2048872613514013","article-title":"Efficacy and safety of tirofiban-supported primary percutaneous coronary intervention in patients pretreated with 600 mg clopidogrel: Results of propensity analysis using the Clinical Center of Serbia STEMI Register","volume":"3","author":"Mrdovic","year":"2014","journal-title":"Eur. Heart J. Acute Cardiovasc. Care"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","article-title":"2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure","volume":"42","author":"McDonagh","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1093\/eurheartj\/ehy462","article-title":"ESC Scientific Document Group Fourth universal definition of myocardial infarction (2018)","volume":"40","author":"Thygesen","year":"2019","journal-title":"Eur. Heart J."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1093\/eurheartj\/ehu505","article-title":"Cardiovascular risk in post-myocardial infarction patients: Nationwide real world data demonstrate the importance of a long-term perspective","volume":"36","author":"Jernberg","year":"2015","journal-title":"Eur. Heart J."},{"key":"ref_23","first-page":"19","article-title":"Significance of the invasive strategy after acute myocardial infarction on prognosis and secondary preventive medication: A nationwide study of 6364 women and 11,915 men","volume":"24","author":"Hvelplund","year":"2012","journal-title":"J. Invasive Cardiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3","DOI":"10.4081\/monaldi.2019.1166","article-title":"High thrombotic risk increases adverse clinical events up to 5 years after acute myocardial infarction. A nationwide retrospective cohort study","volume":"89","author":"Mureddu","year":"2019","journal-title":"Monaldi Arch. Chest Dis."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1177\/2048872617719638","article-title":"Predicting two-year mortality from discharge after acute coronary syndrome: An internationally-based risk score","volume":"8","author":"Pocock","year":"2019","journal-title":"Eur. Heart J. Acute Cardiovasc. Care"},{"key":"ref_26","first-page":"11","article-title":"The Risk of Cardiovascular Events After an Acute Coronary Event Remains High, Especially During the First Year, Despite Revascularization","volume":"69","author":"Abumuaileq","year":"2016","journal-title":"Rev. Espanola Cardiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1016\/j.recesp.2021.02.018","article-title":"Prognosis after an acute myocardial infarction: Survivor life expectancy","volume":"74","author":"Aldama","year":"2021","journal-title":"Rev. Esp. Cardiol. (Engl. Ed.)"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1177\/2048872613507149","article-title":"The prognostic importance of left ventricular function in patients with ST-segment elevation myocardial infarction: The HORIZONS-AMI trial","volume":"3","author":"Ng","year":"2014","journal-title":"Eur. Heart J. Acute Cardiovasc. Care"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1016\/j.jcin.2019.01.248","article-title":"Complete Revascularization Versus Culprit Lesion Only in Patients With ST-Segment Elevation Myocardial Infarction and Multivessel Disease: A DANAMI-3-PRIMULTI Cardiac Magnetic Resonance Substudy","volume":"12","author":"Kyhl","year":"2019","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1706","DOI":"10.1111\/dom.13002","article-title":"Relationship between diabetes and ischaemic injury among patients with revascularized ST-elevation myocardial infarction","volume":"19","author":"Reinstadler","year":"2017","journal-title":"Diabetes Obes. Metab."},{"key":"ref_31","first-page":"E1","article-title":"ESC 2023 guidelines for the treatment of acute coronary syndromes developed by the task force for the treatment of acute coronary syndromes of the European Society of Cardiology (ESC)","volume":"25","author":"Byrne","year":"2023","journal-title":"Eur. Heart J."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1002\/ejhf.11","article-title":"The impact of kidney function on outcomes following high risk myocardial infarction: Findings from 27 610 patients","volume":"16","author":"Moukarbel","year":"2014","journal-title":"Eur. J. Heart Fail."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) (2012). The survival of patients with Heart failure with presserved or reduced left ventricular ejection fraction; an individual patient data meta-analysis. Eur. Heart J., 33, 1750\u20131757.","DOI":"10.1093\/eurheartj\/ehr254"}],"container-title":["Clinics and Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2039-7283\/15\/6\/106\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:43:52Z","timestamp":1760031832000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2039-7283\/15\/6\/106"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,30]]},"references-count":33,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["clinpract15060106"],"URL":"https:\/\/doi.org\/10.3390\/clinpract15060106","relation":{},"ISSN":["2039-7283"],"issn-type":[{"value":"2039-7283","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,30]]}}}