Higher Long-Term Mortality in Patients with Non-ST-Elevation Myocardial Infarction than ST-Elevation Myocardial Infarction after Discharge
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Purpose: This study aimed to compare mortality rates after discharge between the patients with non-ST-elevation myocardial infarction(NSTEMI) and those with ST-elevation myocardial infarction (STEMI), and identify each mortality risk factors in these twotypes of myocardial infarction. Materials and Methods: Between 2011 and 2015, 13105 consecutive patients were enrolled in the Korea Acute Myocardial Infarction-National Institute of Health registry (KAMIR-NIH); 12271 patients with acute myocardial infarction met the inclusion criteriaand were further stratified into the STEMI (n=5828) and NSTEMI (n=6443) groups. The occurrence of mortality and cardiac mortalityat 3 years were compared between groups, and the factors associated with mortality for NSTEMI and STEMI were evaluated. Results: The comparison between these two groups and long-term follow-up outcomes showed that the cumulative rates of allcauseand cardiac mortality were higher in the NSTEMI group than in the STEMI group [all-cause mortality: 10.9% vs. 5.8%; hazardsratio (HR), 0.464; 95% confidence interval (CI), 0.359–0.600, p<0.001; cardiac mortality: 6.6% vs. 3.5%, HR, 0.474; 95% CI,0.344–0.654, p<0.001, respectively). In the NSTEMI group, low left ventricular ejection fraction (LVEF; <40%), no percutaneous coronaryintervention (PCI), old age (≥65 years), and low hemoglobin level (<12 g/dL) were identified as risk factors for 3-year mortality. In the STEMI group, old age, low glomerular filtration rate (<60 mL/min/1.73 m2), low LVEF, high heart rate (>100 beats/min),no PCI, and low hemoglobin level were identified as the risk factors for 3-year mortality. Conclusion: The NSTEMI group had higher mortality compared to the STEMI group during the 3-year clinical follow-up after discharge. Low LVEF and no PCI were the main risk factors for mortality in the NSTEMI group. In contrast, old age and renal dysfunctionwere the risk factors for long-term mortality in the STEMI group.
Abstract
Purpose: This study aimed to compare mortality rates after discharge between the patients with non-ST-elevation myocardial infarction(NSTEMI) and those with ST-elevation myocardial infarction (STEMI), and identify each mortality risk factors in these twotypes of myocardial infarction. Materials and Methods: Between 2011 and 2015, 13105 consecutive patients were enrolled in the Korea Acute Myocardial Infarction-National Institute of Health registry (KAMIR-NIH); 12271 patients with acute myocardial infarction met the inclusion criteriaand were further stratified into the STEMI (n=5828) and NSTEMI (n=6443) groups. The occurrence of mortality and cardiac mortalityat 3 years were compared between groups, and the factors associated with mortality for NSTEMI and STEMI were evaluated. Results: The comparison between these two groups and long-term follow-up outcomes showed that the cumulative rates of allcauseand cardiac mortality were higher in the NSTEMI group than in the STEMI group [all-cause mortality: 10.9% vs. 5.8%; hazardsratio (HR), 0.464; 95% confidence interval (CI), 0.359–0.600, p<0.001; cardiac mortality: 6.6% vs. 3.5%, HR, 0.474; 95% CI,0.344–0.654, p<0.001, respectively). In the NSTEMI group, low left ventricular ejection fraction (LVEF; <40%), no percutaneous coronaryintervention (PCI), old age (≥65 years), and low hemoglobin level (<12 g/dL) were identified as risk factors for 3-year mortality. In the STEMI group, old age, low glomerular filtration rate (<60 mL/min/1.73 m2), low LVEF, high heart rate (>100 beats/min),no PCI, and low hemoglobin level were identified as the risk factors for 3-year mortality. Conclusion: The NSTEMI group had higher mortality compared to the STEMI group during the 3-year clinical follow-up after discharge. Low LVEF and no PCI were the main risk factors for mortality in the NSTEMI group. In contrast, old age and renal dysfunctionwere the risk factors for long-term mortality in the STEMI group.
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