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Causes of In-Hospital Death in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary

Jing Li1, Yinghua Zhang2, Yixin Ma1

  • 1Department of Geriatrics, Xuanwu Hospital Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, China.

The American Journal of Cardiology
|September 29, 2025
PubMed

Insights

In-hospital deaths in ST-segment elevation myocardial infarction patients undergoing percutaneous coronary intervention remain low in Beijing. Most deaths stem from disease severity, not procedure complications, highlighting the importance of hospital volume for quality care.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Public Health

Background:

  • ST-segment elevation myocardial infarction (STEMI) is a critical condition requiring timely intervention.
  • Percutaneous coronary intervention (PCI) is a primary treatment for STEMI.
  • Understanding in-hospital mortality causes is crucial for improving patient outcomes.

Purpose of the Study:

  • To identify and analyze the causes of in-hospital death in STEMI patients treated with PCI in Beijing.
  • To evaluate trends in mortality rates and associated factors over time.
  • To assess the impact of hospital procedure volume on patient mortality.

Main Methods:

  • Retrospective analysis of 56,763 PCI procedures performed between 2010 and 2018 in Beijing.
  • Adjudication of death causes by a review board.
  • Statistical analysis comparing mortality rates across different hospital PPCI volumes.

Main Results:

  • Overall in-hospital mortality was 2.25%, with most deaths (83.6%) due to disease severity (cardiogenic shock, mechanical complications, arrhythmia, heart failure).
  • PPCI-related complications accounted for 16.4% of deaths, with a significant decrease in PPCI-related mortality from 2010 to 2018.
  • Hospitals with higher annual PPCI volumes (>130 procedures) demonstrated lower in-hospital, disease severity-related, and PPCI-related death rates.

Conclusions:

  • In-hospital mortality for STEMI patients undergoing PCI in Beijing is relatively low.
  • Pathophysiological deterioration post-STEMI is the primary driver of mortality.
  • Higher hospital PPCI volume is associated with better quality of care and improved patient survival.

Keywords:
Beijing areaST-segment elevation myocardial infarctioncauses of deathmortalityprimary percutaneous coronary intervention

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