Predictors of Mortality for Patients with ST-Elevation Myocardial Infraction after 2-Year Follow-Up: A ST-Elevation
Marjan Jamalian1, Hamidreza Roohafza1, Azam Soleimani2
1Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Insights
Mortality in ST-elevation myocardial infarction (STEMI) patients is rising globally. Key predictors of STEMI mortality include age, heart rate, ejection fraction, LDL-C, and pre-existing conditions, guiding future interventions.
Area of Science:
- Cardiology
- Public Health
- Clinical Research
Background:
- Global mortality rates for ST-elevation myocardial infarction (STEMI) are on the rise.
- Identifying predictors of mortality in STEMI patients is crucial for improving outcomes.
Purpose of the Study:
- To define and analyze the predictors of mortality in patients diagnosed with STEMI.
- To compare demographic, physiological, and clinical characteristics between STEMI patients who survived and those who died.
Main Methods:
- A cohort of 781 STEMI patients was followed for 2 years.
- Univariate and multiple logistic regression analyses were employed to identify mortality predictors.
- Major Adverse Cardiovascular Events (MACE) were recorded, including nonfatal MI, nonfatal stroke, and cardiovascular death.
Main Results:
- Significant demographic and physiological predictors of mortality included age, sex, transfusion status, STEMI type, extent of coronary artery disease, ventilation requirements, smoking, and diabetes.
- Key clinical factors affecting mortality were ejection fraction (EF), creatinine levels, hemoglobin, low-density lipoprotein-cholesterol (LDL-C), and systolic blood pressure.
- Multiple logistic regression identified age, heart rate (HR), EF, LDL-C, and pre-existing conditions as significant independent predictors of mortality.
Conclusions:
- Specific factors significantly influence STEMI patient mortality.
- Age, HR, EF, LDL-C, and pre-existing conditions are identified as significant predictors of STEMI mortality over a 2-year follow-up.
- Further research across different regions in Iran is recommended to validate these findings.
Background:
Mortality of ST-elevation myocardial infarction (STEMI) patients is increasing in world. This study defines predictors of mortality in patients who have STEMI.
Materials And Methods:
This study was a part of the ST-elevated myocardial infarction cohort study in Isfahan conducted on 876 acute myocardial infarction (MI) followed for 2 years that 781 patient entered. The effect of predictors of mortality includes demographic, physiological, and clinical characterizes compared in two groups alive and died patients. MACE was defined as nonfatal MI, nonfatal stroke, and atherosclerosis cardiovascular disease-related death was recorded. Univariate and multiple logistic regression analyses were performed. All analyses performed using SPSS 20.0. P < 0.05 considered statistically significant.
Results:
A total 781 patients, 117 (13%) that 72 (8.5%) was in-hospital died. The mean (standard deviation) age of the patients was 60.92 (12.77) years and 705 (81.3%) patients were males. Significant factors that affected mortality on analysis of demographic and physiological parameters were age (P < 0.001), sex (P = 0.004), transfusion (P = 0.010), STEMI type (P < 0.001), number epicardial territories >50% (P = 0.001), ventilation options (P < 0.001), smoker (P = 0.003), and diabetes (P = 0.026). Significant clinical factors affected mortality were ejection fraction (EF) (P < 0.001), creatinine (P < 0.001), hemoglobin (P < 0.001), low-density lipoprotein-cholesterol (LDL-C) (P = 0.019), and systolic blood pressure (P < 0.001). Multiple logistics regression model definition significant predictors for mortality were age (P < 0.001), heart rate (HR) (P = 0.007), EF (0.039), LDL-C (P = 0.002), and preangia (P = 0.022).
Conclusion:
The set of factors can increase or decrease mortality in these patients. Significant predictors of mortality STEMI patients by 2-year follow up were age, HR, EF, LDL-C, and preangia. It seems that more articles need to be done in different parts of Iran to confirm the results.
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