{"title":"心肌梗死部位对 STEMI 患者院内预后的影响。","authors":"Chun Shing Kwok, Adnan I Qureshi, Gregory Y H Lip","doi":"10.1097/MCA.0000000000001334","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The territory and vessel involved in ST-elevation myocardial infarction (STEMI) is an important and there are limited contemporary studies from the national perspective.</p><p><strong>Methods: </strong>A retrospective cohort study was undertaken of national representative hospital admission in the National Inpatient Sample with a diagnosis of anterior or non-anterior STEMI between 2017 and 2020. Multiple logistic regression and multiple linear regressions were used to determine if there are any differences in in-hospital mortality, length of stay (LOS) and cost for anterior and non-anterior STEMI.</p><p><strong>Results: </strong>A total of 655 915 admissions with STEMI were included in the analysis (267 920 anterior STEMI, and 387 995 non-anterior STEMI). Non-anterior STEMI was associated with a significant reduction in mortality (OR 0.91 95% CI 0.89-0.99, P = 0.011) and LOS (coefficient -0.15 95% CI -0.22 to -0.08, P < 0.001) compared to anterior STEMI but there was no significant difference in healthcare costs (-297 95% CI -688 to 74). Analyses considering the infarct-related artery showed that the worse outcomes were associated with left main lesions and left-sided lesions had worse outcomes than right coronary artery lesions.</p><p><strong>Conclusion: </strong>Non-anterior STEMI is associated with reduced mortality and LOS compared to anterior STEMI. Left-sided coronary lesions had worse outcomes, compared to right coronary lesions. STEMI should be considered in terms of the vessel or territory affected, in relation to outcomes and healthcare costs.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"286-291"},"PeriodicalIF":1.5000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The impact of the site of myocardial infarction on in-hospital outcomes for patients with STEMI.\",\"authors\":\"Chun Shing Kwok, Adnan I Qureshi, Gregory Y H Lip\",\"doi\":\"10.1097/MCA.0000000000001334\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The territory and vessel involved in ST-elevation myocardial infarction (STEMI) is an important and there are limited contemporary studies from the national perspective.</p><p><strong>Methods: </strong>A retrospective cohort study was undertaken of national representative hospital admission in the National Inpatient Sample with a diagnosis of anterior or non-anterior STEMI between 2017 and 2020. Multiple logistic regression and multiple linear regressions were used to determine if there are any differences in in-hospital mortality, length of stay (LOS) and cost for anterior and non-anterior STEMI.</p><p><strong>Results: </strong>A total of 655 915 admissions with STEMI were included in the analysis (267 920 anterior STEMI, and 387 995 non-anterior STEMI). Non-anterior STEMI was associated with a significant reduction in mortality (OR 0.91 95% CI 0.89-0.99, P = 0.011) and LOS (coefficient -0.15 95% CI -0.22 to -0.08, P < 0.001) compared to anterior STEMI but there was no significant difference in healthcare costs (-297 95% CI -688 to 74). Analyses considering the infarct-related artery showed that the worse outcomes were associated with left main lesions and left-sided lesions had worse outcomes than right coronary artery lesions.</p><p><strong>Conclusion: </strong>Non-anterior STEMI is associated with reduced mortality and LOS compared to anterior STEMI. Left-sided coronary lesions had worse outcomes, compared to right coronary lesions. STEMI should be considered in terms of the vessel or territory affected, in relation to outcomes and healthcare costs.</p>\",\"PeriodicalId\":10702,\"journal\":{\"name\":\"Coronary artery disease\",\"volume\":\" \",\"pages\":\"286-291\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2024-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Coronary artery disease\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/MCA.0000000000001334\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/23 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Coronary artery disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/MCA.0000000000001334","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/23 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
The impact of the site of myocardial infarction on in-hospital outcomes for patients with STEMI.
Background: The territory and vessel involved in ST-elevation myocardial infarction (STEMI) is an important and there are limited contemporary studies from the national perspective.
Methods: A retrospective cohort study was undertaken of national representative hospital admission in the National Inpatient Sample with a diagnosis of anterior or non-anterior STEMI between 2017 and 2020. Multiple logistic regression and multiple linear regressions were used to determine if there are any differences in in-hospital mortality, length of stay (LOS) and cost for anterior and non-anterior STEMI.
Results: A total of 655 915 admissions with STEMI were included in the analysis (267 920 anterior STEMI, and 387 995 non-anterior STEMI). Non-anterior STEMI was associated with a significant reduction in mortality (OR 0.91 95% CI 0.89-0.99, P = 0.011) and LOS (coefficient -0.15 95% CI -0.22 to -0.08, P < 0.001) compared to anterior STEMI but there was no significant difference in healthcare costs (-297 95% CI -688 to 74). Analyses considering the infarct-related artery showed that the worse outcomes were associated with left main lesions and left-sided lesions had worse outcomes than right coronary artery lesions.
Conclusion: Non-anterior STEMI is associated with reduced mortality and LOS compared to anterior STEMI. Left-sided coronary lesions had worse outcomes, compared to right coronary lesions. STEMI should be considered in terms of the vessel or territory affected, in relation to outcomes and healthcare costs.
期刊介绍：
Coronary Artery Disease welcomes reports of original research with a clinical emphasis, including observational studies, clinical trials, translational research, novel imaging, pharmacology and interventional approaches as well as advances in laboratory research that contribute to the understanding of coronary artery disease. Each issue of Coronary Artery Disease is divided into four areas of focus: Original Research articles, Review in Depth articles by leading experts in the field, Editorials and Images in Coronary Artery Disease. The Editorials will comment on selected original research published in each issue of Coronary Artery Disease, as well as highlight controversies in coronary artery disease understanding and management.
Submitted artcles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
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