Assessment of Relation of Hospital and Short and Term (30 days) Mortality of STEMI Patients with Angiographic Parameters and its Contributing Factors

Document Type : Research Paper

Authors

1 Professor of cardiology, Mashhad University of Medical Sciences, Mashhad, Iran

2 Assistant Professor of Cardiology, Mashhad University of Medical Sciences, Mashhad, Iran

3 Cardiologist, Mashhad Iran

4 MSc in Statistics, Mashhad Iran

Abstract

Introduction
Myocardial infarction is one of the most common causes of hospitalization and mortality in human societies. Several researches have performed to identify various risk factors for cardiovascular disease progression and improve treatment methods, medications and therapeutic interventions to minimize mortality. In this study, we have assessed the relation between angiographic findings of patients having myocardial infarction with ST segment elevation and mortality during the hospital course and one month follow up.
Materials and Methods
A total of 156 patients with STEMI Who referred to Imam Reza hospital with the definition of more than 2mm elevation of ST segment in precordial leads and more than 1mm in limb leads also with elevation in cardiac biomarkers were enrolled in this study. Patients’ history obtained and the angiography was carefully reviewed by a cardiologist and variables were recorded. Death of patients during hospitalization and a month after discharge was also recorded.
Results
There was a significant relationship between angiography performance and the presence of thrombus and location of involved vessel, hypotension at presentation, killip class, and tachycardia, hypertension with hospital mortality. Age and calcification were independent factors for one month mortality. In-hospital mortality was 10.3% and one month mortality was 4.3%.
Conclusion
Age and some angiographic factors including the existence of thrombus and anterior wall involvement were significantly correlated with mortality after myocardial infarction.

Keywords


1- National Institutes of Health. Morbidity and Mortality: 2004 Chart Book on Cardiovascular, Lung and Blood
Diseases. Bethesda: US Department on Heart and Human Services, Public Health Service; 2004.
2- Sans S, Kesteloot H, Kromhout D. The burden of cardiovascular diseases mortality in Europe. Task Force of the
European Society of Cardiology on Cardiovascular Mortality and Morbidity Statistics in Europe. Eur Heart J 1997;
18:1231–1248.
3- Fox KA, Cokkinos DV, Deckers J, Keil U, Maggioni A, Steg G. The ENACT study: a pan-European survey of acute
coronary syndromes. European Network for Acute Coronary Treatment. Eur Heart J 2000; 21:1440–1449.
4- WHO MONICA Project Principal Investigators. The World Health Organization MONICA Project (monitoring
trends and determinants in cardiovascular disease): a major international collaboration. J Clin Epidemiol 1988; 41:105–
114.
5- Gurjeva OS, Bukhman G, Murphy S, Cannon CP. Treatment and outcomes of eastern Europeans with coronary
syndromes in OPUS-TIMI 16. Int J Cardiol 2005; 100:1-7.
6- Kramer JM, Newby LK, Chang WC, Simes RJ, Van de Werf F, Granger CB, et al. International variation in the use
of vidence-based medicines for acute coronary syndromes. Eur Heart J 2003; 24:33-41.
7- Ganz P, Ganz W editors. Coronary blood flow and myocardial Ischemia. In: Braunwald E, Zipes P, Libby P, Bonow
O. Braunwald Heart Disease. 8th ed. Philadelphia: W.B. Saunders; 2008. Vol. 2.p.1103-1129.
8- Antmon EM, Braunwald E. Acute myocardial Infarction. In: Braunwald E, Zipes P, libby P, Bonow O, Braunwald
Heart Disease. 8th ed. Philadelphia: W.B. Saunders; 2008. Vol 2.p.1141-1167.
9- Popma J, Kuntz R, Baim D. Percotaneus coronary and intervention. In: Braunwald E, Zipes DP, Libby P. Heart
Disease: A textbook of cardiovascular medicine. 8th ed. Philadelphia: W.B. Saunders; 2008.p.1367-85.
10-Tatu-Chitoiu G, Cinteza M, Dorobantu M, Udeanu M, Manfrini O, Pizzi C, et al. In-hospital case fatality rates for
acute myocardial infarction in Romania. CMAJ 2009; 180:1207-1213.
11- Koeth O, Bauer T, Wienbergen H, Gitt AK, Juenger C, Zeymer U, et al. Maximal Individual Therapy in Acute
Myocardial Infarction Plus (MITRA Plus) Study Group. Angioplasty within 24 h after thrombolysis in patients with
acute ST-elevation myocardial infarction: current use, predictors and outcome. Results of the MITRA plus registry. Clin
Res Cardiol 2009; 98:107-113.
12- Greig D, Corbalán R, Castro P, Campos P, Lamich R, Yovaniniz P. [Mortality of patients with ST-elevation acute
myocardial infarction treated with primary angioplasty or thrombolysis]. Rev Med Chil 2008; 136:1098-106. Epub
2008 Nov 12.