Causes of death in patients with ST-segment elevation myocardial infarction following primary percutaneous coronary intervention / 中华全科医师杂志

ABSTRACT

Objective To analyze the causes of death in patients with ST-segment elevation myocardial infarction (STEMI) following primary percutaneous coronary intervention (PCI).Methods The clinical data of 1 213 patients [845 males and 368 females,mean age(60.83±12.31) years] with STEMI who underwent direct PCI in Linyi People's Hospital from January 2010 to May 2014 and followed-up for 3-7 years were retrospectively analyzed.The causes of death and predictors were analyzed.Results Among 1 135 patients,129 died during the follow-up.Thirty nine patients died in the first 2 weeks and 97.4％ (38/39)due to cardiovascular causes;29 died between 2 weeks and 1 year and 62.1％ (18/29)due to cardiovascular causes;61 died after 1 year and 40.9％ (25/61)from cardiovascular causes,19.7％ (12/61) from cancer,14.8％ (9/61)from stroke.Multivariate Cox regression analysis showed that age ≥70 years,increase of serum creatinine,LVEF≤40％,symptom-to-balloon time＞360 min,cardiac shock,triple vessel lesion,TIMI blood flow less than grade 3 were independent predictors of all death.Conclusion Cardiovascular conditions are the main cause of death in the first year and non-cardiovascular conditions are the main cause of death 1 year after primary PCI in patients with STEMI.It is suggested that long-term surviving patients should also pay close attention to non-cardiac risk factors.