Early- and late-term clinical outcome and their predictors in patients with ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction

Hyun Woong Park, Chang Hwan Yoon, Si Hyuck Kang, Dong Ju Choi, Hyo Soo Kim, Myeong Chan Cho, Young Jo Kim, Shung Chull Chae, Jung Han Yoon, Hyeon Cheol Gwon, Young Keun Ahn, Myung Ho Jeong

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Abstract

Backgrounds The disparity between ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) remains controversial. We compared clinical outcomes and prognostic factors between STEMI and NSTEMI using large-scale registry data. Methods We recruited 28,421 patients with STEMI (n = 16,607) and NSTEMI (n = 11,814) between November 2005 and April 2010 from a nationwide registry in Korea. We performed landmark analysis of cardiac death, recurrent acute myocardial infarction (re-AMI), revascularization, and major adverse cardiac events (MACE) at 30 days (early term) and 1 year (late term) after admission. Results Patients with NSTEMI had a greater number of co-morbidities than STEMI patients. Early term MACE (6.9% vs. 4.5%, p < 0.001) and cardiac death (6.1% vs. 3.7%, p < 0.001) were higher in STEMI patients. However, late-term MACE (8.0% vs. 9.1%, p = 0.007), cardiac death (1.9% vs. 2.6%, p = 0.001), and re-AMI (0.6% vs. 1.3%, p < 0.001) were lower in the STEMI group. The independent predictors of cardiac death were old age, renal dysfunction, LV dysfunction, Killip class, post-thrombolysis in myocardial infarction (TIMI) flow, and major bleeding in both groups. Female gender, previous ischemic heart disease, diabetes, current smoking, multivessel disease, and body mass index were MI type- or time-dependent predictors. Conclusion The STEMI group displayed poor early term clinical outcome, whereas the NSTEMI group displayed poor late-term clinical outcome. The STEMI and NSTEMI groups had different predictor profiles for cardiac death, suggesting that different strategies are required for improving the late-term outcome of STEMI and NSTEMI patients.

Original languageEnglish
Pages (from-to)254-261
Number of pages8
JournalInternational Journal of Cardiology
Volume169
Issue number4
DOIs
Publication statusPublished - 2013 Nov 15

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All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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