In-hospital mortality of acute ST-elevation myocardial infarction (STEMI) and its predictors-using Yazd Cardiovascular Diseases Registry, YCDR.

Abstract

Background: The purpose of this study was estimate and identify in hospital mortality predictors factors for patients with acute ST elevation myocardial infarction (STEMI).

Methods: This study is a retrospective cohort study based on data from the Yazd Cardiovascular Diseases Registry (YCDR) from 2015-2018 in Yazd Province, Iran, focusing on hospitalized patients with ST-elevation myocardial infarction (STEMI). The primary outcome was in-hospital mortality in STEMI patients. A total of 1861 patients with STEMI were analyzed. Multivariable logistic regression was used to determine death predictive factors for in-hospital mortality in STEMI patients. The significance level of the model was considered to be 5% and the software was used for analysis.

Results: The study included 1,861 patients with STEMI. Among them, 103 (5.5%) individuals died during admission the hospital. After multivariable logistic regression, the following variables were identified as death predictive factors for in-hospital mortality of STEMI: having a history of CVA (OR: 5.6, 95% CI: 2.2-20.3), killip class IV (OR: 6.4, 95%CI: 1.5-11.2), lower ejection fraction (OR: 3.6, 95% CI: 1.2-9.8), lower HDL cholesterol (OR: 1.2, 95% CI: 1.01-2.3), and lower hemoglobin (OR: 1.4, 95% CI: 1.3-2.9).

Conclusion: This study found that lower ejection fraction, lower hemoglobin levels, Killip class IV, having a history of CVA, and low HDL cholesterol levels are important death predictive factors for hospital mortality in patients with STEMI. Health policy in STEMI management must consider these factors to improve hospital prognosis.