Risk Assessment for Mortality in Patients With St-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention: A Retrospective Cohort Study Publisher



Oraii A¹ ; Shafeghat M^{2, 3} ; Ashraf H^{4, 5} ; Soleimani A⁶ ; Kazemian S⁴ ; Sadatnaseri A⁶ ; Saadat N⁶ ; Danandeh K¹ ; Akrami A⁷ ; Balali P¹ ; Fatahi M¹ ; Karbalai Saleh S⁶
Source: Health Science Reports Published:2024

Abstract

Background and Aims: Primary percutaneous coronary intervention (PCI) is the treatment of choice in ST-elevation myocardial infarction (STEMI) patients. This study aims to evaluate predictors of in-hospital and long-term mortality among patients with STEMI undergoing primary PCI. Methods: In this registry-based study, we retrospectively analyzed patients with STEMI undergoing primary PCI enrolled in the primary angioplasty registry of Sina Hospital. Independent predictors of in-hospital and long-term mortality were determined using multivariate logistic regression and Cox regression analyses, respectively. Results: A total of 1123 consecutive patients with STEMI were entered into the study. The mean age was 59.37 ± 12.15 years old, and women constituted 17.1% of the study population. The in-hospital mortality rate was 5.0%. Multivariate analyses revealed that older age (odds ratio [OR]: 1.06, 95% confidence interval [CI]: 1.02–1.10), lower ejection fraction (OR: 0.97, 95% CI: 0.92–0.99), lower mean arterial pressure (OR: 0.95, 95% CI: 0.93–0.98), and higher white blood cells (OR: 1.17, 95% CI: 1.06–1.29) as independent risk predictors for in-hospital mortality. Also, 875 patients were followed for a median time of 21.8 months. Multivariate Cox regression demonstrated older age (hazard ratio [HR] = 1.04, 95% CI: 1.02–1.06), lower mean arterial pressure (HR = 0.98, 95% CI: 0.97–1.00), and higher blood urea (HR = 1.01, 95% CI: 1.00–1.02) as independent predictors of long-term mortality. Conclusion: We found that older age and lower mean arterial pressure were significantly associated with the increased risk of in-hospital and long-term mortality in STEMI patients undergoing primary PCI. Our results indicate a necessity for more precise care and monitoring during hospitalization for such high-risk patients. © 2024 The Authors. Health Science Reports published by Wiley Periodicals LLC.