Mortality Rate and Predictive Factors for Death in Patients with ST-Elevation Acute Coronary Syndrome at Sisaket Hospital

Abstract

Background: Mortality rate of ST-elevation acute coronary syndrome in Sisaket province is high and associated with patients with diabetes, hypertension, hyperlipidemia, smoking, and obesity. Identifying predictive factors were crucial for reducing mortality rate and establishing a cardiac network.
Objectives: The purpose is to identify the mortality rate and the predictive factors in patients with ST-elevation acute coronary syndrome in Sisaket Hospital.
Methods: A case-control study was conducted on patients with ST-elevation acute coronary syndrome in Sisaket hospital between 1^st. October 2023 and 30^th. September 2025. Data collection using medical records and the Thai ACS registry program. The endpoint was all-cause mortality and predictive factors of death.
Results: Of the 451 patients were included in the study. The mortality rate was 16.2% (73 patients). Majority of patients were elderly (age > 60 years old) about 73.1%. Predictive factors significantly associated with death were late presentation (aOR=4.12, 95%CI 1.12 – 15.15, p = 0.033), congestive heart failure on admission (aOR=3.39, 95%CI 1.01 – 11.34, p = 0.047), postprocedural cardiogenic shock (aOR=4.24, 95%CI 1.08 – 16.63, p =0.038) and renal failure acquired dialysis (aOR=10.46 ,95% CI 1.33-82.25, p = 0.026). However, patients treated with percutaneous coronary intervention (PCI), with a 93% reduction in the odds of death (aOR=0.069, 95% CI 0.01 – 0.28, p = 0.001) compared to the non-PCI group and statistically significant.
Conclusion: Mortality rate of patients with ST-elevation acute coronary syndrome in Sisaket Hospital is still high. Late presentation, congestive heart failure on admission, postprocedural cardiogenic shock, and renal failure requiring acquired dialysis are significant predictors of death.