In-Hospital and Long-Term Outcomes of ST-Segment Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention

Authors : Doğaç OKŞEN, Mert SARILAR, Gürsu DEMİRCİ, İsmail HABERAL, Okay ABACI

Pages : 23-32

View : 26 | Download : 7

Publication Date : 2022-04-18

Article Type : Research Paper

Abstract :Introduction: We evaluated in-hospital and long-term outcomes of patients who underwent primary percutaneous coronary intervention insert ignore into journalissuearticles values(PCI); in a tertiary center. Patients and Methods: We examined 1550 patients insert ignore into journalissuearticles values(mean age= 58.5 years, 83.1% male); admitted with acute ST-segment elevation myocardial infarction insert ignore into journalissuearticles values(AMI); who underwent primary PCI and were followed-up prospectively. The primary outcomes were in-hospital death and major adverse cardiac events insert ignore into journalissuearticles values(MACE); at follow-up. Results: The mean duration of ischemia at admission was 2.85 ± 2.49 hours; 10.3% of the patients were Killip class III or IV. The mean door-to-device time was 43 insert ignore into journalissuearticles values(29-52); minutes. During hospitalization, all-cause mortality occurred in 73 patients insert ignore into journalissuearticles values(4.7%);. Multivariate analysis revealed that advanced age, impaired left ventricular ejection function, high Killip functional class, hemoglobin level at admission, ventricular arrhythmias, and advanced atrioventricular block were independent predictors of poor prognosis insert ignore into journalissuearticles values(OR= 1.07, 0.93, 15.34, 1.44, 3.79, and 4.26 respectively);. Among discharged patients with a median 49.5 insert ignore into journalissuearticles values(25-73); months follow-up, 12.4% of them died, 12.5% had a recurrent myocardial infarction insert ignore into journalissuearticles values(MI);, and 2.3% had a cerebrovascular accident. The strongest independent MACE predictors were impaired left ventricular function, poor glomerular filtration rate, low albumin level, and a history of cerebrovascular disease insert ignore into journalissuearticles values(HR= 0.97, 0.99, 0.65, and 2.50, respectively);. Secondary outcomes were contrast-induced acute kidney injury insert ignore into journalissuearticles values(16.7%);, ventricular arrhythmias insert ignore into journalissuearticles values(6.1%);, advanced atrioventricular block insert ignore into journalissuearticles values(3.7%);, atrial fibrillation insert ignore into journalissuearticles values(7.6%);, and major bleeding insert ignore into journalissuearticles values(1.6%);. Conclusion: AMI still has a poor long-term prognosis. These results emphasize the advantages of rapid, non-delayed revascularization. Patients should be followed-up closely after discharge in both the short- and long-term.
Keywords : Angioplasty, myocardial infarction, reperfusion, myocardial revascularization, in hospital mortality