Left-Behind Status Worsens Prognosis of ST-Elevation Myocardial Infarction in Elderly Patients from Southwest China
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Maolin Cao1, Zhe Zhang2, Shichuan Li3
1Department of Cardiology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China (mainland).
Insights
Individuals left behind experienced a higher risk of major adverse cardiovascular and cerebrovascular events (MACCEs) after ST-elevation myocardial infarction (STEMI). This left-behind status independently predicts poorer STEMI prognosis.
Area of Science:
- Cardiology
- Public Health
- Geriatrics
Background:
- Left-behind individuals often face unique socioeconomic and health challenges.
- Understanding their health outcomes post-myocardial infarction is crucial for targeted interventions.
Purpose of the Study:
- To investigate the association between left-behind status and prognosis in patients with ST-elevation myocardial infarction (STEMI).
- To identify if left-behind status is an independent predictor of adverse cardiovascular events.
Main Methods:
- A cohort of 1,015 STEMI patients from four tertiary medical centers in southwest China were analyzed.
- Patients were categorized into 'left-behind' and 'not-left-behind' groups.
- Major adverse cardiovascular and cerebrovascular events (MACCEs) were assessed using Kaplan-Meier curves and multivariate Cox regression.
Main Results:
- The left-behind group was older and had a higher incidence of adverse events (26.2% vs. 14.8%) over 18 months.
- Left-behind patients showed higher levels of alanine aminotransferase, LDL cholesterol, and cardiac troponin I.
- Multivariate analysis revealed a 1.778-fold higher risk of MACCEs in the left-behind group (95% CI: 1.241-2.547, P=0.002).
Conclusions:
- Left-behind status is an independent predictor of adverse outcomes in STEMI patients.
- This highlights a vulnerable population requiring specific attention in cardiovascular care.
- Further research into the mechanisms and interventions for this group is warranted.
Abstract:
BACKGROUND This study aimed to assess the association between left-behind status and the prognosis of ST-elevation myocardial infarction (STEMI). MATERIAL AND METHODS A total of 1 015 patients with STEMI patients from 4 tertiary medical centers in southwest China were enrolled and categorized into left-behind and not-left-behind groups. The primary endpoints were major adverse cardiovascular and cerebrovascular events (MACCEs), which were assessed with Kaplan-Meier curves. Multivariate Cox regression analyses were used to explore the predictive value of left-behind status for MACCEs. RESULTS Patients in the left-behind group were older than those in the not-left-behind group (70 vs. 65 years, P<0.001). The patients in the left-behind group had a lower incidence of history of coronary heart disease and diabetes mellitus than those in the not-left-behind group. Meanwhile, the left-behind group had higher levels of alanine aminotransferase (42 vs. 31, P<0.001), low-density lipoprotein cholesterol concentration (2.64 vs. 2.62, P=0.001) and cardiac troponin I (5.11 vs. 2.84, P=0.001) than the not-left-behind group. During the 18-month follow-up, the left-behind group experienced a higher rate of adverse events than the not-left-behind group (123/26.2% vs. 81/14.8%, P<0.001). After multivariate adjustment, the left-behind group also had a 1.778-fold (95% CI: 1.241-2.547, P=0.002) higher risk of experiencing MACCEs than the not-left-behind group. CONCLUSIONS Left-behind status is an independent predictor of STEMI prognosis.
