Factors Associated with In-Hospital Mortality Among ST-Elevation Myocardial Infarction (STEMI) Patients Undergoing Percutaneous Coronary Intervention at Nakhonpathom Hospital
Keywords:
STEMI, mortalityAbstract
Objectives: The purpose is to identify the predictive factors of in-hospital mortality in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) at Nakhonpathom Hospital, a tertiary care center in Thailand.
Methods: A retrospective study was conducted on STEMI patients who undergoing primary PCI at Nakhonpathom Hospital between January 1, 2021 and December 31, 2023. Baseline characteristics and angiographic data were reviewed and recorded. The study endpoint was all-cause in-hospital mortality.
Results: Of the 252 patients were included in the study. The in-hospital mortality rate was 12.3% (31 patients). The mean age of the patients was 63 years, and 73% were male. Cardiogenic shock on admission was present in 19% of the patients. The median diagnosis-to-device time was 91 minutes. After adjustment for baseline variables, the factors significantly associated with mortality were cardiogenic shock on admission (OR 5.11, 95% CI 2.02–12.91, p < .001); final TIMI flow grade 0/1 after the procedure (OR 16.43, 95% CI 1.39–13.02, p = .011); left ventricular ejection fraction less than 40% (OR 2.71, 95% CI 1.11–6.77, p = .029); and age over 60 years (OR 2.32, 95% CI 0.81–6.65, p = .12) which was not statistically significant.
Conclusion: Cardiogenic shock, left ventricular function, and final TIMI flow are significant predictors of adverse outcomes in unselected patients with STEMI undergoing primary PCI at Nakhonpathom Hospital.
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