Borderline trend towards long-term mortality benefit from drug eluting stents implantation in ST-elevation myocardial infarction patients in Poland-data from NRDES registry

Objective To investigate the clinical characteristics and long-term mortality of patients with ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) after orthopaedic surgery. Methods This retrospective, single-centre study enrolled patients that underwent inpatient orthopaedic surgery from 2009 to 2017 in Beijing Jishuitan Hospital. The patients were screened for a cardiac troponin I elevation and fulfilled the Fourth Universal Definition of Myocardial Infarction within 30 days of surgery. Results A total of 180 patients that developed perioperative myocardial infarction (MI) were included in the study. Among them, 14 patients (7.8%) were classified as STEMI, and 166 (92.2%) had NSTEMI. Compared with those with NSTEMI, STEMI patients had significantly higher 30-day and long-term mortality rates (50.0% versus 5.4%; 71.4% versus 22.3%; respectively). Multivariate Cox regression model analysis among the entire cohort demonstrated that STEMI (hazard ratio [HR] 5.78, 95% confidence interval [CI] 2.50, 13.38) and prior MI (HR 2.35, 95% CI 1.02, 5.38) were the most significant independent predictors of long-term mortality. Conclusion Perioperative MI after orthopaedic surgery was associated with a high mortality rate. STEMI was independently associated with a significant increase in short- and long-term mortality.

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Impact of age on short- and long-term mortality of patients with ST-elevation myocardial infarction in the VIENNA STEMI network

Wiener klinische Wochenschrift ◽

10.1007/s00508-017-1250-7 ◽

2017 ◽

Vol 130 (5-6) ◽

pp. 172-181 ◽

Cited By ~ 4

Author(s):

Paul Michael Haller ◽

Bernhard Jäger ◽

Serdar Farhan ◽

Günter Christ ◽

Wolfgang Schreiber ◽

...

Keyword(s):

Myocardial Infarction ◽

St Elevation Myocardial Infarction ◽

Short And Long Term ◽

St Elevation ◽

Long Term Mortality

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The effect of serum potassium level on in-hospital and long-term mortality in ST elevation myocardial infarction

International Journal of Cardiology ◽

10.1016/j.ijcard.2016.07.024 ◽

2016 ◽

Vol 221 ◽

pp. 505-510 ◽

Cited By ~ 14

Author(s):

Muhammed Keskin ◽

Adnan Kaya ◽

Mustafa Adem Tatlısu ◽

Mert İlker Hayıroğlu ◽

Osman Uzman ◽

...

Keyword(s):

Myocardial Infarction ◽

Serum Potassium ◽

Potassium Level ◽

Serum Potassium Level ◽

St Elevation Myocardial Infarction ◽

St Elevation ◽

Long Term Mortality

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Abstract 13193: Impact of “Off-Peak” Versus “Peak” Hour Coronary Interventions for ST-Elevation Myocardial Infarction on Adverse Outcomes

Circulation ◽

10.1161/circ.132.suppl_3.13193 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Jae S Lee ◽

Gabriel Redel-Traub ◽

Michael Kim ◽

Perwaiz Meraj ◽

Christina Brennan ◽

...

Keyword(s):

Myocardial Infarction ◽

Propensity Score ◽

Adverse Outcomes ◽

St Elevation Myocardial Infarction ◽

Coronary Interventions ◽

St Elevation ◽

Peak Versus ◽

Versus Peak ◽

Long Term Mortality

Background: In addition to patient-dependent factors, whether the time of arrival of the patient to the hospital with ST-elevation myocardial infarction (STEMI) might play a role in subsequent adverse outcomes following primary percutaneous coronary interventions (PCI) is not well studied. Method: 856 PCI procedures for patients presenting with STEMI from two large hospitals in the health system were analyzed. Peak hours were defined as procedures performed between 7 AM and 7 PM on weekdays. Off-peak hours were defined as procedures performed between 7 PM and 7 PM on weekdays and weekends. Unadjusted and propensity score-adjusted analyses were performed to analyze the following inpatient outcomes: composite of death/MI/stroke, composite of bleeding events, composite of death/MI/stroke/bleeding endpoints, and long-term mortality. Results: Of 856 PCIs, 407 (47.5%) were performed during the peak hours. In both unadjusted and propensity score-adjusted analyses, no significant differences in adverse outcomes and long-term mortality were observed in patients who had PCIs during off-peak and peak hours (see Table). In addition, a separate analysis performed on patients who underwent primary PCIs between 7 AM-7 PM (“Morning”) versus 7 PM-7 AM (“Evening”) on all days showed no difference in the inpatient adverse outcomes and long-term mortality (Adjusted long term mortality: HR 0.79 (95% CI 0.40-1.56), p=0.49). Conclusion: Primary PCIs performed on patients presenting with STEMI during off-peak versus peak hours results in similar inpatient adverse outcomes and long-term mortality.

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Abstract 108: Contemporary Timing and Etiology of Mortality in ST-Elevation Myocardial Infarction

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/hcq.13.suppl_1.108 ◽

2020 ◽

Vol 13 (Suppl_1) ◽

Author(s):

Zachary J Il'Giovine ◽

Anirudh Kumar ◽

Chetan Huded ◽

Venu Menon ◽

Amar Krishnaswamy ◽

...

Keyword(s):

Myocardial Infarction ◽

Hospital Discharge ◽

Systems Of Care ◽

Significant Risk ◽

Coronary Intervention ◽

St Elevation Myocardial Infarction ◽

Early Reperfusion ◽

St Elevation ◽

Long Term Mortality

Background: Acute treatment of ST-elevation myocardial infarction (STEMI) has focused on early reperfusion, prompt defibrillation, and appropriate mechanical support to mitigate short-term mortality. Long-term patterns of death in a contemporary population are not well described. Methods: We reviewed consecutive cases of STEMI treated with percutaneous coronary intervention (PCI) at our center between January 1, 2011, and December 31, 2016, and divided patients into two groups: uncomplicated STEMI (US) and complicated STEMI (CS). CS was defined by presence of cardiac arrest or cardiogenic shock, ascertained from first-medical-contact to device time for PCI. We assessed for differences in characteristics and short- and long-term mortality between the groups. Results: We identified 1,272 patients with STEMI; 214 of which were CS (16.8%). Those with CS were significantly more likely to have heart failure (22.9% vs 11.3%, p<0.001), kidney disease (38.2% vs. 21.0%, p<0.001), cerebrovascular disease (18.7% vs 11.0%, p=0.003), peripheral vascular disease (16.8% vs 7.9%, p<0.001), and left main or left anterior descending culprit vessel (51.9% vs. 40.3%, p<0.002). Total in-hospital mortality was 5.0% (63 patients), with 19.6% (42/214) and 2.0% (21/1058) of those with CS and US respectively (p<0.001). Among 1209 of patients that survived to hospital discharge, total long-term mortality was 10% (121 patients) of which 18.0% (31/172) had CS and 8.7% (90/1037) had US (p=0.001) over mean follow-up of 3.1±1.9 years. Of those, 52% and 50%, respectively, were from non-cardiovascular etiologies (Figure) including malignancy (13% vs. 22%), infection (22% vs. 19%), or other causes (17% vs. 9.0%). Conclusion: Despite advances in the in-hospital care of patients with STEMI, there remains a significant risk of long-term mortality for both patients with uncomplicated and complicated STEMI. A substantial proportion of overall STEMI mortality now occurs after hospital discharge predominantly due to non-cardiovascular causes. Systems of care to mitigate this long-term risk are needed.

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