Long-term all-cause mortality rate after ST-elevation myocardial infarction and its predictors: ST Elevation Myocardial Infarction Cohort in Isfahan Study.

BACKGROUND

ST-elevation myocardial infarction (STEMI) remains a significant global health concern, especially in low- and middle-income regions. This study aimed to identify long-term prognostic factors among STEMI patients, offering insights into improving patient outcomes.

MATERIALS AND

METHODS

This study represents the 5-year follow-up of STEMI patients in the SEMI Cohort in Isfahan registry, a clinical-based registry of STEMI patients in Isfahan, Iran, from October 2015. All patients with STEMI within 24 h of symptom onset underwent a comprehensive evaluation. The dataset included demographic information, laboratory data, medical history, and clinical in-hospital data. Over 5 years, annual follow-ups were conducted to track hospitalization and patient all-cause mortality. Utilizing univariate and multivariate Cox regression proportional hazard modeling, we aimed to identify predictors of death.

RESULTS

In this study, involving 759 patients (621 men and 138 women) with a mean age of 58.92 ± 11.79 years, 158 deaths (21%) with a mean age of 70.33 ± 12.66 years occurred after STEMI. In the multiple model our analysis revealed that the following variables significantly increased all-cause mortality independently: Older age (hazard ratio [HR]: 1.070, P < 0.001), lower body mass index (HR: 0.890, P < 0.001), hypertension status (HR: 2.441, P < 0.001), lower systolic blood pressure at initial presentation (HR: 0.983, P < 0.001), number of affected epicardial territories (HR: 2.979, P < 0.001), lower last ejection fraction before discharge (HR: 0.951, P < 0.001), lower hemoglobin level (HR: 0.747, <0.001), higher plasma glucose level (HR: 1.005, P < 0.001), and in-hospital complications (HR: 7.646, P < 0.001).

CONCLUSION

This study identified a range of factors that predict STEMI-related mortality. These findings are pivotal for future planning and decision-making regarding appropriate diagnostic and therapeutic strategies during patient follow-up, contributing to improved outcomes in STEMI care.