Higher Long-Term Mortality in Patients with Non-ST-Elevation Myocardial Infarction than ST-Elevation Myocardial...

Area of Science:

• Cardiology
• Clinical Research
• Public Health

Background:

• Myocardial infarction (MI) is a leading cause of death globally.
• Distinguishing between ST-elevation MI (STEMI) and non-ST-elevation MI (NSTEMI) is crucial for prognosis and treatment.
• Long-term mortality and risk factors following MI require continuous investigation.

Purpose of the Study:

• To compare 3-year post-discharge mortality rates between NSTEMI and STEMI patients.
• To identify specific mortality risk factors for both NSTEMI and STEMI cohorts.

Main Methods:

• Analysis of 12,271 acute myocardial infarction patients from the Korea Acute Myocardial Infarction-National Institute of Health (KAMIR-NIH) registry (2011-2015).
• Stratification into STEMI (n=5828) and NSTEMI (n=6443) groups.
• Comparison of 3-year all-cause and cardiac mortality, and evaluation of associated risk factors.

Main Results:

• NSTEMI patients exhibited higher cumulative 3-year all-cause (10.9% vs. 5.8%) and cardiac mortality (6.6% vs. 3.5%) compared to STEMI patients.
• In NSTEMI, mortality risk factors included low left ventricular ejection fraction (<40%), absence of percutaneous coronary intervention (PCI), older age (≥65 years), and low hemoglobin (<12 g/dL).
• In STEMI, risk factors for mortality were older age, low glomerular filtration rate (<60 mL/min/1.73 m²), low LVEF, high heart rate (>100 bpm), no PCI, and low hemoglobin.

Conclusions:

• NSTEMI is associated with significantly higher 3-year mortality than STEMI.
• Low LVEF and lack of PCI are primary mortality predictors in NSTEMI.
• Older age and renal dysfunction are key long-term mortality risks in STEMI.