Twelve-Year History of STEMI Management in Tehran Heart Center: Concomitant Reduction of In-Hospital Mortality and Hospitalization Length.
Arch Iran Med
; 23(8): 514-521, 2020 08 01.
Article
em En
| MEDLINE
| ID: mdl-32894962
ABSTRACT
BACKGROUND:
Cardiovascular-related death remains the major cause of mortality in Iran despite significant improvements in its care. In the present study, we report the in-hospital mortality, hospitalization length, and treatment methods for patients with ST-elevation myocardial infarction (STEMI) in Tehran Heart Center (THC).METHODS:
Records pertaining to patients with STEMI from March 2006 to March 2017 were extracted from the databases of THC. Besides a description of temporal trends, multivariable regression analysis was used to find factors associated with in-hospital mortality.RESULTS:
During the study period, 8,295 patients were admitted with STEMI with a mean age of 60.4 ± 12.5 years. Men accounted for 77.5% of the study population. Hospitalization length declined from 8.4 to 5.2 days, and in-hospital mortality was reduced from 8.0% to 3.9% (both P values < 0.001). In a multivariable model adjusted for age, sex, conventional cardiac risk factors, prior cardiac history, and indices of event severity, primary percutaneous coronary intervention (PCI) (OR 0.280, 95% CI 0.186 to 0.512; P<0.001), coronary artery bypass graft (CABG) surgery (OR 0.482, 95% CI 0.220 to 0.903; P=0.025), and rescue or facilitated PCI (OR 0.420, 95% CI 0.071 to 0.812; P=0.001) were all associated with reduced in-hospital mortality in comparison with medical treatment. Furthermore, primary PCI was a crucial protective factor against prolonged length of hospital stay (OR 0.307, 95% CI 0.266 to 0.594; P<0.001).CONCLUSION:
In-hospital mortality and hospitalization length were almost halved during the study period, and primary PCI has now replaced thrombolysis in the management of STEMI.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Mortalidade Hospitalar
/
Infarto do Miocárdio com Supradesnível do Segmento ST
/
Tempo de Internação
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
Asia
Idioma:
En
Revista:
Arch Iran Med
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Irã