Variations in all-cause mortality in patients with myocardial infarction with elevation of the st segment according to the type of reperfusion therapy received (data of Ryazan region, 2018-2020)
- Authors: Parshikova E.N.1, Filippov E.V.2
-
Affiliations:
- Lubertsy Regional Hospital
- Ryazan State Medical University
- Issue: Vol 28, No 4 (2020)
- Pages: 479-487
- Section: Original study
- Submitted: 28.10.2020
- Accepted: 12.11.2020
- Published: 15.12.2020
- URL: https://journals.eco-vector.com/pavlovj/article/view/48650
- DOI: https://doi.org/10.23888/PAVLOVJ2020284479-487
- ID: 48650
Cite item
Abstract
Aim. To assess variations in all-cause mortality in patients with past myocardial infarction with elevation of the ST segment (STEMI) according to the type of reperfusion therapy received.
Materials and Methods. Among 1456 patients hospitalized with acute coronary syndrome with elevation of the ST segment, 848 cases were randomly selected for analysis. Acquisition of information of the endpoint (i.e., death from any cause) was conducted over 18 months. The published data were received on January 10, 2020, and the median observation time was 20.8 months (17.4; 23.6).
Results. The highest all-cause mortality observed after 18 months (42.3%) was found in the group of patients who did not receive reperfusion therapy. The 30-day mortality rates in the group receiving thrombolytic therapy (TLT) and the group without reperfusion therapy did not show significant differences (20.3% vs. 26.2%, р>0.05). The hospital, 30-day, 12-month, and 18-month all-cause mortality rates in the group receiving percutaneous coronary intervention (PCI) were 8.4%, 10.6%, 16.6%, and 18.3%, respectively; these values are significantly lower compared with the corresponding rates in the group that did not receive reperfusion (19.5%, 26.2%, 36.2%, and 42.3%, respectively; р<0.05). The most remarkable differences in the frequency of the endpoint were recorded at the end of the 18-month period. Specifically, mortality in the group without reperfusion mortality (42.3%) was significantly higher (р<0.05) compared with those in the groups who received TLT (27.1%), PCI (18.3%), and TLT + PCI (13.1%).
Conclusion. The lowest all-cause mortality recorded over 18 months of observation was noted in the group treated by the pharmaco-invasive approach (TLT + PCI). The highest mortality over the same period was observed in the group of patients who did not receive reperfusion therapy.
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About the authors
Elena N. Parshikova
Lubertsy Regional Hospital
Email: philpoiuy@yandex.ru
ORCID iD: 0000-0003-0349-3456
SPIN-code: 2809-2781
Head of the Emergency Department
Russian Federation, Lubertsy, Moscow regionEvgenii V. Filippov
Ryazan State Medical University
Author for correspondence.
Email: dr.philippov@gmail.com
ORCID iD: 0000-0002-7688-7176
SPIN-code: 2809-2781
ResearcherId: O-1490-2016
MD, PhD, Head of the Department of Outpatient Therapy and Preventive Medicine
Russian Federation, RyazanReferences
- Alkhalil M, Choudhury RP. Reperfusion Treatment in Late Presentation Acute Myocardial Infarction: Timing Is Not Everything. Circulation: Cardiovascular Interventions. 2018;11(9):e007287. doi:10. 1161/CIRCINTERVENTIONS.118.007287
- Erlikh AD. Six-month outcomes in acute coronary syndrome patients included in the registry Record-3. Russian Journal of Cardiology. 2017;22(11):8-14. (In Russ). doi: 10.15829/1560-4071-2017-11-8-14
- Martsevich SYu, Semenova YuV, Kutishenko NP, et al. LIS-3 register of the acute coronary syndrome: what has changed in a «portrait» of a patient and short-term outcomes of the disease compared to LIS-1 register. Rational Pharmacotherapy in Cardiology. 2017;13(1):63-8. (In Russ). doi:10. 20996/1819-6446-2017-13-1-63-68
- Kutishenko NP, Kalaydzhyan EP, Sichinava DP, et al. Outpatient registry of patients with acute myocardial infarction (PROFILE-IM): data on prehospital therapy in comparison with the LIS-3 registry. Rational Pharmacotherapy in Cardiology. 2018;14(1):88-93. (In Russ). doi: 10.20996/1819-6446-2018-14-1-88-93
- Erlikh AD. Twelve months outcomes in patients with acute coronary syndrome, by the national registry RECORD-3. Russian Journal of Cardiology. 2018;(3):23-30. (In Russ). doi: 10.15829/1560-4071-2018-3-23-30
- Russian Statistical Yearbook 2019. Moscow; 2019. Available at: https://rosstat.gov.ru/storage/media-bank/Ejegodnik_2019.pdf. Accessed: 2020 October 27. (In Russ).
- Sanchis-Gomar F, Perez-Quilis C, Leischik R, et al. Epidemiology of coronary heart disease and acute coronary syndrome. Annals of Translational Medicine. 2016;4(13):256. doi: 10.21037/atm.2016.06.33
- Biery DW, Berman AN, Singh A, et al. Association of Smoking Cessation and Survival Among Young Adults with Myocardial Infarction in the Partners YOUNG-MI Registry. JAMA Network Open. 2020; 3(7):e209649. doi: 10.1001/jamanetworkopen.2020. 9649
- Fazel R., Joseph T.I., Sankardas M.A., et al. Comparison of Reperfusion Strategies for ST-Segment-Elevation Myocardial Infarction: A Multivariate Network Meta-analysis. Journal of the American Heart Association. 2020;9(12):e015186. doi:10. 1161/JAHA.119.015186
- Ibanez B, James S, Agewall S, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). European Heart Journal. 2018;39(2):119-77. doi: 10.1093/eurheartj/ehx393
- Order of the Government of the Ryazan region of 27 June 2019 №301-p «Ob utverzhdenii regional’noy programmy Ryazanskoy oblasti «Bor’ba s serdechno-sosudistymi zabolevaniyami». Available at: http://docs.cntd.ru/document/553385694. Accessed: 2020 October 27. (In Russ).
- Peiyuan H, Jingang Y, Haiyan X, et al. The Comparison of the Outcomes between Primary PCI, Fibrinolysis, and No Reperfusion in Patients ≥ 75 Years Old with ST-Segment Elevation Myocardial Infarction: Results from the Chinese Acute Myocardial Infarction (CAMI) Registry. PLoS One. 2016; 11(11):e0165672. doi: 10.1371/journal.pone.0165672
- Limwattananon C, Jaratpatthararoj J, Thungthong J, et al. Access to reperfusion therapy and mortality outcomes in patients with ST-segment elevation myocardial infarction under universal health coverage in Thailand. BMC Cardiovascular Disorders. 2020;20. doi: 10.1186/s12872-020-01379-3
- Lozhkina NG, Khasanova MK, Stafeeva EA, et al. Prediction of remote outcomes of acute myocardial infarction with stable ST-segment elevation on ECG in real clinical practice. Modern Problems of Science and Education. 2018;(6). Available at: http://science-education.ru/ru/article/view?id=28172. Accessed: 2020 October 27. (In Russ).
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