Differences in Clinical Outcomes Between Patients With ST-Elevation Versus Non-ST-Elevation Acute Myocardial
Doo Sun Sim1, Ju Han Kim, Myung Ho Jeong
1The Heart Research Center of Chonnam National University Hospital, Gwangju, Korea.
Insights
Acute myocardial infarction (AMI) patients with ST-segment elevation (STEMI) were younger and had poorer outcomes than those without ST-segment elevation (NSTEMI). However, 12-month survival rates were similar, suggesting NSTEMI requires intensive follow-up.
Area of Science:
- Cardiology
- Public Health
Background:
- Acute myocardial infarction (AMI) incidence is rising in Korea.
- Understanding clinical outcomes for ST-segment elevation myocardial infarction (STEMI) versus non-ST-segment elevation myocardial infarction (NSTEMI) is crucial.
Purpose of the Study:
- To analyze 12-month clinical outcomes in a large cohort of Korean AMI patients.
- To compare outcomes between STEMI and NSTEMI based on the Korea Acute Myocardial Infarction Registry.
Main Methods:
- Analysis of 13,133 AMI patients from a nationwide prospective registry.
- Stratification of patients into STEMI and NSTEMI groups.
- Comparison of demographic, clinical, and survival data.
Main Results:
- STEMI patients were younger, more often male smokers, with worse left ventricular function and higher cardiac death rates.
- NSTEMI patients had more multi-vessel disease, complex lesions, and comorbidities.
- In-hospital and 1-month survival favored NSTEMI, but 12-month survival was comparable.
Conclusions:
- NSTEMI patients exhibit worse clinical outcomes than STEMI patients.
- Intensified clinical follow-up is recommended for NSTEMI patients.
- Registry data provides valuable insights into AMI management in Korea.
Abstract:
In Korea, the incidence of acute myocardial infarction has been increasing rapidly. Twelve-month clinical outcomes for 13,133 patients with acute myocardial infarction enrolled in the nationwide prospective Korea Acute Myocardial Infarction Registry study were analyzed according to the presence or absence of ST-segment elevation. Patients with ST-segment elevation myocardial infarction (STEMI) were younger, more likely to be men and smokers, and had poorer left ventricular function with a higher incidence of cardiac death compared to patients with non-ST-segment elevation myocardial infarction (NSTEMI). NSTEMI patients had a higher prevalence of 3-vessel and left main coronary artery disease with complex lesions, and were more likely to have co-morbidities. The in-hospital and 1-month survival rates were higher in NSTEMI patients than in STEMI patients. However, 12-month survival rates was not different between the two groups. In conclusion, NSTEMI patients have worse clinical outcomes than STEMI patients, and therefore should be treated more intensively during clinical follow-up.
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