Risk factors of short term mortality in patients with acute ST-elevation myocardial infarction complicated with fatal arrhythmia / 中华心血管病杂志

ABSTRACT

<p><b>OBJECTIVE</b>To explore the independent risk factors associated with short term mortality in patients with ST-segment elevation acute myocardial infarction (STEMI) complicated with fatal arrhythmia.</p><p><b>METHODS</b>We analyzed data from Chinese STEMI patients with fatal arrhythmia enrolled in the CREATE trial. Predictors of 30-day mortality after STEMI were identified by univariate and multivariate logistic regression analysis using baseline and therapy variables.</p><p><b>RESULTS</b>The overall 30-day mortality of STEMI patients complicated with fatal arrhythmia among the 718 patients [(66.1 ± 11.9) years and 62.4% male] was 52.9%. Logistic regression analysis showed that age (OR = 1.82, 95%CI1.449-2.285), anterior infarction (OR = 4.419, 95%CI2.645-7.384), heart rate > 60 bpm (OR = 3.32, 95%CI1.898- 5.808), killip class IV (OR = 3.686, 95%CI1.684-8.06), admission hemoglobin A1c < 5.6% (OR = 2.564, 95%CI1.199-5.484), no use of ACEI (OR = 1.827, 95%CI1.099-3.038) and no use of lipid-low drugs (OR = 2.034, 95%CI1.196-3.458) were independent risk factors for short term mortality after STEMI. The receiver operating characteristic curve for predicting the death of the baseline and clinical variable models was 0.830 (95%CI 0.796-0.865) and 0.866 (95%CI 0.835-0.896), respectively.</p><p><b>CONCLUSION</b>The 30-day mortality of patients with STEMI complicated with fatal arrhythmia is high. Age, anterior infarction, heart rate > 60 bpm, killip class IV, admission hemoglobin A1c level < 5.6%, no use of ACEI and no use of lipid-low drugs are independent risk factors for 30-day mortality in these patients.</p>