Impact of primary percutaneous coronary intervention on ST-segment elevation myocardial infarction patients: A
Eza Nawzad Saeed1, Abdulsatar Kamil Faeq2
1Department of Medicine, Hawler Medical University, Erbil 44001, Kurdistan, Iraq. demolali542@gmail.com.
Insights
Prompt arrival at the hospital after symptom onset significantly improves survival for ST-segment elevation myocardial infarction (STEMI) patients. This study identified key factors influencing mortality in STEMI cases.
Area of Science:
- Cardiology
- Emergency Medicine
- Public Health
Background:
- ST-segment elevation myocardial infarction (STEMI) is a leading global cause of mortality.
- Understanding predictors of mortality in STEMI is crucial for improving patient outcomes.
- Primary percutaneous coronary intervention (PPCI) is a standard treatment for STEMI.
Purpose of the Study:
- To identify key factors influencing in-hospital mortality in STEMI patients undergoing PPCI.
- To evaluate the impact of time from symptom onset to hospital arrival on STEMI prognosis.
Main Methods:
- A cohort of 96 STEMI patients undergoing PPCI at Erbil Cardiac Center was studied.
- Clinical histories, angiographic findings, and complications were analyzed.
- One-month follow-up assessments were conducted to determine mortality rates.
Main Results:
- In-hospital and 30-day mortality rates were 11.2% and 2.3%, respectively.
- Independent predictors of in-hospital mortality included atypical presentation, cardiogenic shock, chronic kidney disease, and coronary artery disease severity.
- Patients who did not survive had a significantly longer time from symptom onset to hospital arrival (6.92 ± 3.86 h) compared to survivors (3.61 ± 1.67 h).
Conclusions:
- Early hospital arrival after symptom onset is a critical factor in improving STEMI patient survival.
- Prompt medical intervention is essential for better prognosis in STEMI.
- Identifying and addressing mortality predictors can enhance STEMI management strategies.
Background:
Myocardial infarction, particularly ST-segment elevation myocardial infarction (STEMI), is a key global mortality cause. Our study investigated predictors of mortality in 96 STEMI patients undergoing primary percutaneous coronary intervention at Erbil Cardiac Center. Multiple factors were identified influencing in-hospital mortality. Significantly, time from symptom onset to hospital arrival emerged as a decisive factor. Consequently, our study hypothesis is: "Reducing time from symptom onset to hospital arrival significantly improves STEMI prognosis."
Aim:
To determine the key factors influencing mortality rates in STEMI patients.
Methods:
We studied 96 consecutive STEMI patients undergoing primary percutaneous coronary intervention (PPCI) at the Erbil Cardiac Center. Their clinical histories were compiled, and coronary evaluations were performed via angiography on admission. Data included comorbid conditions, onset of cardiogenic shock, complications during PPCI, and more. Post-discharge, one-month follow-up assessments were completed. Statistical significance was set at P < 0.05.
Results:
Our results unearthed several significant findings. The in-hospital and 30-d mortality rates among the 96 STEMI patients were 11.2% and 2.3% respectively. On the investigation of independent predictors of in-hospital mortality, we identified atypical presentation, onset of cardiogenic shock, presence of chronic kidney disease, Thrombolysis In Myocardial Infarction grades 0/1/2, triple vessel disease, ventricular tachycardia/ventricular fibrillation, coronary dissection, and the no-reflow phenomenon. Specifically, the recorded average time from symptom onset to hospital arrival amongst patients who did not survive was significantly longer (6.92 ± 3.86 h) compared to those who survived (3.61 ± 1.67 h), P < 0.001. These findings underscore the critical role of timely intervention in improving the survival outcomes of STEMI patients.
Conclusion:
Our results affirm that early hospital arrival after symptom onset significantly improves survival rates in STEMI patients, highlighting the critical need for prompt intervention.
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