[Short-term and long-term mortality comparison between myocardial infarction with and without ST segment elevation
Luis Gajardo N1, Juan Barramuño D1, Alicex González M2
1Departamento de Medicina Interna, Facultad de Medicina, Universidad de Concepción, Concepción, Chile.
Insights
Patients with ST-elevation myocardial infarction (STEMI) face higher early mortality, while non-ST-elevation myocardial infarction (NSTEMI) patients experience greater long-term mortality. Overall survival rates were similar between STEMI and NSTEMI groups after four years.
Area of Science:
- Cardiology
- Clinical Research
- Public Health
Background:
- ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) are distinct acute coronary syndromes.
- Understanding differential mortality patterns is crucial for patient management and prognosis.
Purpose of the Study:
- To compare early and late mortality in patients diagnosed with STEMI versus NSTEMI.
- To analyze survival rates in these patient groups following coronary angioplasty.
Main Methods:
- Retrospective study of 1838 patients treated between 2013-2015.
- Inclusion criteria: diagnosis of STEMI or NSTEMI requiring coronary angioplasty.
- Analysis included descriptive statistics, multivariate analysis, and survival analysis up to 4 years.
Main Results:
- STEMI patients were younger with higher rates of hypertension and smoking.
- NSTEMI patients had more diabetes, lower kidney function, and complex coronary artery disease.
- Overall survival at 4 years was 76% with no significant difference between groups.
- STEMI group showed a higher risk of death within 30 days (p=0.012).
- After 30 days, NSTEMI patients had higher mortality (80.8% vs 75.6% survival).
Conclusions:
- No significant difference in overall long-term mortality between STEMI and NSTEMI patients.
- STEMI is associated with increased early mortality risk.
- NSTEMI is associated with increased long-term mortality risk.
Objectives:
To compare the early and late mortality of patients that have suffered an ST segment elevation myocardial infarction (STEMI) and a non-ST segment elevated myocardialinfarction (NSTEMI).
Methods:
Retrospective study of patients treated at the Regional Clinical Hospital of Concepción from January the 1rst 2013 to December 31 rst 2015, with diagnostic of STEMI and NSTEMI that required coronary angioplasty during their hospitalization. Descriptive and multivariate analysis was performed to compare mortality rates between both populations before 30 days and in follow-up at 4 years.
Results:
1838 patients were included with an average follow-up of 82 months. The population with STEMI was 921 and was younger, with a higher prevalence of arterial hypertension and smoking. The population with NSTEMI had a higher prevalence of diabetes mellitus, a lower glomerular filtration rate, and a higher incidence of left main coronary artery disease and chronic occlusions. At the end of follow-up, the overall survival rate was 76%, with no significant difference between the two groups. Patients with STEMI had twice the risk of dying in the first 30 days (Long Rank: 0.012). After 30 days, mortality was higher in the NSTEMI group (80.8% vs 75.6%).
Conclusions:
This study did not show significant differences in overall mortality during prolonged follow-up of patients with STEMI and NSTEMI. The STEMI group had a higher risk of early death, while the NSTEMI group had higher long-term mortality.
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