Prevalence and predictors associated with in-hospital mortality in acute ST segment elevation myocardial infarction after reperfusion therapy in developing country

Abstract

Background: The prevalence and predictors of in-hospital mortality in the unselected patients with STsegment elevation myocardial infarction (STEMI) after reperfusion therapy with fibrinolytic or primary percutaneous coronary intervention (PCI) in developing country have not well established. Methods:We conducted a retrospective cohort study design. All admission records of acute ST elevation myocardial infarction at Suratthani hospital between October 2015 and September 2017. Results:The finding between October 2015 and September 2017, a total of 431 patients received reperfusion therapy and were included in the present study. Majority of the patient were male (80.5%), almost half of the population had anterior wall MI, 32 patients died (7.4%), and 399 survived during the index hospitalization. The prevalence of chronic kidney disease, anterior wall MI, cardiogenic shock and cardiac arrest in non-survived group was higher than the survived group. Echocardiogram was performed in 299 patient (69.4%) and the median left ventricular ejection fraction (LVEF) in overall population was 51%.After adjustment for baseline variables, LVEF (aOR 0.91, 95% CI, 0.83-0.98, P=0.02) and cardiac arrest at presentation (aOR 22, 95% CI, 1.22-410.05, P=0.036) were independently associated with in-hospital mortality.Conclusions: LVEF and cardiac arrest at presentation were independently associated with in-hospital mortality in STEMI patients receiving reperfusion therapy either fibrinolytic therapy or primary PCI.

Sex Differences in the Effects of COPD on Incidence and Outcomes of Patients Hospitalized with ST and Non-ST Elevation Myocardial Infarction: A Population-Based Matched-Pair Analysis in Spain (2016–2018)

“…By contrast, undergoing a PCI was associated with a reduction in IHM in all study groups. Invasive management in patients with STEMI and NSTEMI was previously associated with lower mortality, compared with noninvasive management [ 28 , 29 ].…”

In Hospital Outcome of Patients with Acute St-Elevation Myocardial Infarction Requiring Temporary Pacemaker

“…Temporary artificial pacing is a public health issue in poor countries [7]. Cardiovascular disease is the leading cause of mortality globally [8].…”

Impact of COVID-19 pandemic on STEMI thrombolysis and Emergency Department's performance in a non-PCI capable tertiary hospital

“…In these countries, thrombolysis (alone or as part of pharmacoinvasive therapy) is used only when primary PCI cannot be performed in a timely manner [ 10 ]. However, pharmacological thrombolysis remains the primary STEMI reperfusion strategy in many low to medium-income countries, including Malaysia (>70%), due to the limited PCI-capable facilities [ 5 , [12] , [13] , [14] ]. To date, data on the impact of COVID-19 pandemic on STEMI thrombolysis in the non-PCI-capable centre is lacking.…”