Long-term follow-up in patients with ST-segment elevation myocardial infarction who underwent primary percutaneous...

Area of Science:

• Cardiology
• Interventional Cardiology
• Public Health

Background:

• Long-term outcomes following primary percutaneous coronary intervention (pPCI) for ST-segment elevation myocardial infarction (STEMI) are not well-defined.
• Existing risk-stratification systems for post-pPCI patients are lacking for routine clinical use.

Purpose of the Study:

• To describe long-term mortality beyond 5 years after pPCI for STEMI.
• To identify predictors of long-term cardiovascular mortality.
• To develop a predictive model for cardiovascular death risk stratification.

Main Methods:

• Retrospective, academic, two-centre analysis of 5263 consecutive STEMI patients treated with pPCI (March 2008 - December 2019).
• Data collected from prospective local registries and initial hospitalization records.
• Multivariate analysis and predictive model development using identified mortality predictors.

Main Results:

• Cardiovascular mortality was the predominant cause of death (65.0%) during long-term follow-up (up to 12 years), with myocardial infarction-associated mortality at 27.2%.
• Significant predictors for long-term cardiovascular mortality included age, diabetes mellitus, renal insufficiency, heart failure, Killip class, and successful pPCI.
• A predictive model demonstrated high discrimination (C-statistic = 0.84) for cardiovascular death risk.

Conclusions:

• Cardiovascular diseases are the primary cause of long-term mortality in Central European patients after pPCI for STEMI.
• The developed predictive model offers valuable risk stratification, potentially guiding aggressive secondary prevention strategies for high-risk individuals.