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Funding Acknowledgements Type of funding sources: None. Background Patients discharged after an acute coronary syndrome (ACS) have substantial mortality risk, especially during the first year. Purpose To determine differences between first year and long-term all-cause mortality of patients after an ACS and identify its risk predictors. Methods This is a post-hoc analysis of the baseline data from 360 patients after ACS with a median follow up 3.2 years (IQR: 2.5-3.8) that enrolled in a prospective randomized controlled trial. Mortality rates with 95% confidence intervals (CIs) were estimated by Kaplan–Meier method. Multivariate Cox proportional hazards regression analyses of clinical parameters and cardiac biomarkers were performed to identify predictors for all-cause mortality within first year and thereafter. Results In our cohort, all-cause mortality incidence per 100 person-years at risk within and after first year was 4.9 and 2.1, respectively (RR = 2.3, p &amp;lt; 0.001). Notably, 83% of the deaths during the first year were attributed to any cardiovascular cause, dropped to 50% after the first year. Baseline NT-proBNP value and prior myocardial infarction were the main independent predictors of all-cause mortality for both first year and beyond time periods (Table 1). Οn the contrary, severe chronic kidney disease lost predictive power after 1 year. Conclusion We observed higher all-cause mortality rate during the first year, mainly driven by cardiovascular death. History of myocardial infarction and baseline NT-proBNP levels outperformed any other clinical variable or biomarker for long-term all-cause mortality in  post-ACS patients. Predictors of long-term all-cause death Variables Univariate analysis Multivariate analysis HR (95% CI) P-value HR (95% CI) P-value Age per 1-year increase 1.06 (1.03 - 1.10) &amp;lt;0.001 1.02 (0.99 - 1.06) 0.11 Female 1.07 (0.79 - 3.71) 0.17 HTN 2.52 (1.14 - 5.63) 0.02 Diabetes 2.06 (1.03 - 4.15) 0.04 CKD IV or V 9.01 (3.89 - 20.86) &amp;lt;0.001 0.88 (0.26 - 2.95) 0.83 History of MI 0.55 (0.26 - 1.17) 0.001 3.28 (1.05 - 7.17) 0.002 HFrEF 1.25 (0.51 - 3.04) 0.62 Family history of CAD 0.55 (0.26 - 1.17) 0.12 NT-proBNP* 1.92 (1.46 - 2.51) &amp;lt;0.001 1.70 (1.22 - 2.36) 0.001 hs-cTnT* 1.15 (0.91 - 1.44) 0.27 LDL-C 0.99 (0.98 - 1.00) 0.22 *Natural logarithms Abstract Figure. Kaplan-Meier for all-cause mortality

Predictors of all-cause mortality within and beyond 1 year after an acute coronary syndrome