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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
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Affiliations:
- Lubertsy Regional Hospital
- Ryazan State Medical University
- Issue: Vol 28, No 4 (2020)
- Pages: 479-487
- Section: Original study
- URL: https://journals.eco-vector.com/pavlovj/article/view/48650
- DOI: https://doi.org/10.23888/PAVLOVJ2020284479-487
- ID: 48650
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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
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