Factors that impact in-hospital mortality due to STEMI versus NSTEMI in a first percutaneous coronary intervention:...

Area of Science:

• Cardiology
• Clinical Research
• Public Health

Background:

• Acute coronary syndrome (ACS) is a leading cause of mortality globally and in Colombia.
• Timely intervention is crucial for managing potentially fatal ACS.
• In 2021, Colombia recorded 51,988 deaths attributed to ACS.

Purpose of the Study:

• To compare clinical characteristics of ST-elevation myocardial infarction (STEMI) and NSTEMI.
• To determine in-hospital survival rates (<30 days) for STEMI and NSTEMI patients undergoing percutaneous coronary intervention (PCI).
• To identify factors associated with in-hospital mortality in STEMI and NSTEMI patients post-PCI.

Main Methods:

• Prospective cohort study conducted from 2020-2021 in Medellín, Colombia.
• Survival analysis utilized the Kaplan-Meier method.
• Cox regression models identified predictive factors for in-hospital mortality.

Main Results:

• The study included 504 participants; 53% had STEMI and 47% had NSTEMI. Median age was 64 years, with 66% males.
• In-hospital survival was 98.3% for NSTEMI and 93.7% for STEMI.
• For STEMI, mortality predictors included age > 65, diabetes, Killip IV, and post-PCI arrhythmia. For NSTEMI, predictors were cardiogenic shock and post-PCI arrhythmia.

Conclusions:

• NSTEMI patients with Killip IV and post-PCI arrhythmia represent a high-risk group with increased in-hospital mortality compared to STEMI patients.
• Diabetes is identified as a modifiable risk factor potentially influencing early survival in STEMI patients post-PCI.
• These findings highlight the need for targeted management strategies for high-risk ACS patient subgroups.