Time-Point Clinical Outcomes in Patients With Acute Myocardial Infarction: One Step for Personalized Medicine

Limited data exist regarding time-point risk stratification models after acute coronary syndrome. This study aimed to investigate time-point mortality rates in patients with acute myocardial infarction, focusing on comparison by type of myocardial infarction, in a real-world cohort. A total of 12,836 patients from a nationwide Korean registry were analyzed. Mortality rates at yearly, monthly, and weekly time points after admission were calculated by dividing the number of deaths during a specific period by the number of patients at risk in the same period for ST-elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) groups. In the first week after admission, patients with STEMI had a significantly higher mortality rate than patients with NSTEMI (4.62% vs 1.79%, p <0.001). However, this trend was inverted since the second week. The higher mortality rate in patients with STEMI versus NSTEMI was inverted since the second week for male patients but only since the tenth week for female patients. Temporal assessment of correlates of mortality revealed that several baseline variables, including Killip class, systolic blood pressure, total cholesterol, and STEMI diagnosis, had significantly different effects on deaths over time. In conclusion, temporal assessment of time-point outcomes from the Korean registry revealed that an initially higher mortality rate in patients with STEMI versus NSTEMI was inverted in the second week. This outcome assessment could be a step toward developing an advanced risk prediction model for time-course personalized medicine. Further studies are needed to clarify this issue.