Mortality and morbidity of acute ST segment elevation myocardial infarction in the current era
1Department of Cardiology, Christian Medical College, Vellore. cardio2@cmcvellore.ac.in
Insights
This study found a 16.9% in-hospital mortality rate for acute ST-elevation myocardial infarction patients in India. This rate is higher than Western reports, highlighting a need for improved acute myocardial infarction care.
Area of Science:
- Cardiology
- Public Health
Background:
- Acute myocardial infarction (AMI) mortality has decreased globally.
- Limited data exists on AMI outcomes in Indian tertiary care settings.
- This study addresses the paucity of literature on in-hospital mortality and 30-day events in Indian AMI patients.
Purpose of the Study:
- To determine the in-hospital mortality rate.
- To assess the 30-day event rate (mortality, reinfarction, recurrent angina, heart failure).
- To analyze outcomes in patients with acute ST-segment elevation myocardial infarction (STEMI) in an Indian tertiary care hospital.
Main Methods:
- Retrospective analysis of 1320 consecutive STEMI patients.
- Data collected on demographics, risk factors, infarction type, and treatment.
- In-hospital mortality and 30-day post-discharge events were analyzed.
Main Results:
- Mean age was 56 years; 83.8% were male.
- High prevalence of risk factors: 43.1% smokers, 38.2% hypertensive, 40.2% diabetic.
- In-hospital mortality was 16.9%; 30-day event rate (death, reinfarction, angina) was 18.8%.
Conclusions:
- The in-hospital mortality for STEMI in this Indian tertiary care center is 16.9%.
- This rate is significantly higher than reported in Western countries.
- Findings suggest a need for enhanced management strategies for STEMI in India.
Background:
The mortality rate of acute myocardial infarction has come down considerably in the past three decades. In view of paucity of literature on this issue, present study was done to find out the in-hospital mortality and 30-day event rate in patients with acute ST segment elevation myocardial infarction presenting to a tertiary care hospital in India.
Methods And Results:
Consecutive patients (n=1320) with the diagnosis of acute ST segment elevation myocardial infarction admitted in our institution were included in this study. The in-hospital mortality and 30-day event rates (mortality, reinfarction, recurrent angina and heart failure) were analyzed. The mean age of study population was 56+/-13 years. There were 1106 (83.8%) males and 214 (16.2%) females; 569 (43.1%) patients were smokers, 504 (38.2%) patients had hypertension, 531 (40.2%) patients were diabetic and 154 (11.7%) patients had past history of myocardial infarction. Anterior wall infarction was present in 752 (57%) patients, 517 (39.1%) patients had inferior wall infarction, 324 (62.7%) patients had associated right ventricular or posterior wall infarction and 51 (3.9%) patients had antero-inferior infarction; 1093 patients (82.8%) received thrombolytic therapy while 227 patients were not thrombolyzed due to various reasons. Of the total 1320 patients, 223 (16.9%) patients died during in-hospital stay while 1097 patients were discharged from the hospital in stable condition after a mean stay of 5.3+/-3.4 days. Thirty-day event rates of death, reinfarction and recurrent angina following hospital discharge was 18.8% (134/715 patients) and 36 (5%) patients presented with heart failure.
Conclusions:
The in-hospital mortality rate of acute ST segment elevation myocardial infarction in a tertiary care hospital is 16.9%, which is higher compared to reports from the West.
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