Inhospital mortality of acute myocardial infarction in Saudi Arabia

ABSTRACT

In a retrospective study, medical records of 145 patients with confirmed diagnosis of acute myocardial infarction were reviewed. The overall inhospital mortality rate was only 6.9%; this is lower than the previous 20% rate reported from our center. Variables with the strongest univariate association with high inhospital mortality were higher Killip class, development of a new bilateral bundle-branch block [present 66.7%, absent 5.6%; P=0.01], cardiac arrest [present 45.5%, absent 3.7%; P<0.0001], streptokinase [given 0%, not given 10%; P=0.03], development of a new complete heart block [present 37.5%, absent 5.1%; P=0.01], beta-blocker [given 2.4%, not given 12.9%; P=0.02], nitroglycerin [given 3.8%, not given 41.7%; P<0.0001], and aspirin [given 3.3%, not given 13.8%; P=0.04]. In a stepwise discriminant analysis [in descending order of importance], higher Killip class, nitroglycerin therapy, development of a new bilateral bundle-branch block, and cardiac arrest were the only variables found to influence inhospital mortality independently. We conclude that [1] there has been a decrease in inhospital mortality of acute myocardial infarction in our center as compared with the earlier reported data; [2] nitroglycerin was the only drug to influence inhospital mortality independently; and [3] patients with other poor prognostic features may benefit from aggressive invasive intervention