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In-hospital mortality among consecutive patients with ST-Elevation myocardial infarction in modern primary percutaneous intervention era ~ Insights from 15-year data of single-center hospital-based registry ~.

Authors :
Takagi, Kensuke
Tanaka, Akihito
Yoshioka, Naoki
Morita, Yasuhiro
Yoshida, Ruka
Kanzaki, Yasunori
Watanabe, Naoki
Yamauchi, Ryota
Komeyama, Shotaro
Sugiyama, Hiroki
Shimojo, Kazuki
Imaoka, Takuro
Sakamoto, Gaku
Ohi, Takuma
Goto, Hiroki
Ishii, Hideki
Morishima, Itsuro
Murohara, Toyoaki
Source :
PLoS ONE. 6/11/2021, Vol. 16 Issue 6, p1-13. 13p.
Publication Year :
2021

Abstract

Objective: To clarify the association of detailed angiographic findings with in-hospital outcome after primary percutaneous coronary intervention (p-PCI) for ST-elevation myocardial infarction (STEMI) in Japan. Background: Data regarding the association of detailed angiographic findings with in-hospital outcome after STEMI are limited in the p-PCI era. Methods: Between January-2004 and December-2018, 1735 patients with STEMI (mean age, 68.5 years; female, 24.6%) who presented to the hospital in the 24-hours after symptom onset and underwent p-PCI were evaluated using the disease registries. The registry is an ongoing, retrospective, single-center hospital-based registry. Results: The 30-day mortality rate and in-hospital mortality rate were 7.7% and 9.2%, respectively. Independent predictors of in-hospital mortality were ejection fraction (EF) < 40% [adjusted Odds Ratio (aOR), 4.446, p < 0.001], culprit lesions in the left coronary artery (LCA) (aOR, 2.940, p < 0.001) compared with those in the right coronary artery, Killip class > II (aOR, 7.438; p < 0.001), chronic kidney disease (CKD) (aOR, 4.056; p < 0.001), final thrombolysis in myocardial infarction (TIMI) grades 0/1/2 (aOR, 1.809; p = 0.03), absence of robust collaterals (aOR, 17.309; p = 0.01) and hypertension (aOR, 0.449; p = 0.01). Conclusions: Among the consecutive patients with STEMI, the in-hospital mortality rate after p-PCI significantly improved in the second half. Not only CKD, Killip class > II, and EF < 40%, but also the angiographic findings such as culprit lesions in the LCA, absence of very robust collaterals, and final TIMI grades <3 were associated with an increased risk of in-hospital mortality. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
19326203
Volume :
16
Issue :
6
Database :
Academic Search Index
Journal :
PLoS ONE
Publication Type :
Academic Journal
Accession number :
150878701
Full Text :
https://doi.org/10.1371/journal.pone.0252503