Risk assessment for mortality in patients with ST‐elevation myocardial infarction undergoing primary percutaneous coronary intervention: A retrospective cohort study

Abstract

AbstractBackground and AimsPrimary percutaneous coronary intervention (PCI) is the treatment of choice in ST‐elevation myocardial infarction (STEMI) patients. This study aims to evaluate predictors of in‐hospital and long‐term mortality among patients with STEMI undergoing primary PCI.MethodsIn this registry‐based study, we retrospectively analyzed patients with STEMI undergoing primary PCI enrolled in the primary angioplasty registry of Sina Hospital. Independent predictors of in‐hospital and long‐term mortality were determined using multivariate logistic regression and Cox regression analyses, respectively.ResultsA total of 1123 consecutive patients with STEMI were entered into the study. The mean age was 59.37 ± 12.15 years old, and women constituted 17.1% of the study population. The in‐hospital mortality rate was 5.0%. Multivariate analyses revealed that older age (odds ratio [OR]: 1.06, 95% confidence interval [CI]: 1.02–1.10), lower ejection fraction (OR: 0.97, 95% CI: 0.92–0.99), lower mean arterial pressure (OR: 0.95, 95% CI: 0.93–0.98), and higher white blood cells (OR: 1.17, 95% CI: 1.06–1.29) as independent risk predictors for in‐hospital mortality. Also, 875 patients were followed for a median time of 21.8 months. Multivariate Cox regression demonstrated older age (hazard ratio [HR] = 1.04, 95% CI: 1.02–1.06), lower mean arterial pressure (HR = 0.98, 95% CI: 0.97–1.00), and higher blood urea (HR = 1.01, 95% CI: 1.00–1.02) as independent predictors of long‐term mortality.ConclusionWe found that older age and lower mean arterial pressure were significantly associated with the increased risk of in‐hospital and long‐term mortality in STEMI patients undergoing primary PCI. Our results indicate a necessity for more precise care and monitoring during hospitalization for such high‐risk patients.