Prognostic factors of in-hospital mortality in all comers with ST elevation myocardial infarction undergoing primary percutaneous coronary intervention

Abstract

BackgroundThe prognostic factors of in-hospital mortality in all comers and unselected patients with ST elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) have not been well established. Objective To identify the predictive factors of inhospital mortality in patients with STEMI undergoing primary PCI in a tertiary heart centre. Methods Between January 2008 and December 2011, all patients with STEMI undergoing primary PCI were retrospectively included in this study. Baseline characteristics and angiographic data were reviewed and recorded. The study endpoint was all-cause in-hospital mortality.Results Of the 541 patients included in the study, 63 (11.6%) died during hospitalisation. Cardiogenic shock at admission was recorded in 301 patients (55.6%) and 424 patients (78%) had multivessel disease. Median door-to-device time was 65 min. After adjustment for baseline variables, the factors associated with in-hospital mortality included age >60 years (OR 2.98, 95% CI 1.17 to 7.05; p=0.01), left ventricular ejection fraction <40% (OR 2.53, 95% CI 1.20 to 5.36; p=0.02), and final TIMI flow grade 0/1 (OR 20.55, 95% CI 3.49 to 120.94; p=0.001). Conclusions Age, left ventricular function and final TIMI flow are significant predictors of adverse outcomes in unselected patients with STEMI undergoing primary PCI.

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

“…The our study was demonstrated that the lower LVEF (equal or less than 40%) and cardiac arrest at presentation were independent factors associated with in-hospital mortality of all comer STEMI patient. This finding was similar to the prognostic factor values for 1-year mortality in LVEF in acute coronary syndrome (both non-STEMI and STEMI) (11) and prognostic factor of in-hospital mortality in all STEMI undergoing primary PCI (12).…”

The long-term prognostic value of E/e’ in patients with ST segment elevation myocardial infarction

“…Despite technical advances in the field of coronary intervention, the development of major adverse cardiac events (MACEs) after acute myocardial infarction (MI) remains a major cause of mortality and morbidity worldwide. 1 , 2 Effective risk stratification is crucial for high-risk patients to decide on early aggressive management, which may improve the overall clinical outcomes. 3 Prior studies have suggested various predictors of MACEs in patients with MI, including high-scoring systems (SYNTAX, TIMI, and GRACE), infarct size, and certain echocardiographic parameters.…”

“… 5 However, several data on patients with ST segment elevation MI (STEMI) alone exist, resulting from a high percentage of critical initial conditions. 2 , 6 , 7 Because of its heterogeneous pathophysiology, STEMI is considered as a differentiated disease entity compared with non-ST segment elevation MI (NSTEMI). 8 , 9 Furthermore, predicting clinical outcomes in STEMI applying left ventricular ejection fraction (LVEF) and left ventricular (LV) diastolic function still remains controversial.…”