Independent Predictors of Cardiac Mortality and Hospitalization for Heart Failure in a Multi-Ethnic Asian ST-segment Elevation Myocardial Infarction Population Treated by Primary Percutaneous Coronary Intervention

Autor: Khim Leng Tong, Jack Wei Chieh Tan, Anders Sahlén, Nicolas Foin, Heerajnarain Bulluck, Philip Wong, David Foo, Huay C. Tan, Tian H. Koh, Mark Y. Chan, Aaron Sung Lung Wong, Chee W. Lee, Terrance Chua, Ling L. Foo, Khung Keong Yeo, Soo Teik Lim, Huili Zheng, Derek J. Hausenloy
Jazyk: angličtina
Rok vydání: 2019
Předmět:
0301 basic medicine
Male
medicine.medical_treatment
Myocardial Infarction
lcsh:Medicine
Cohort Studies
Electrocardiography
0302 clinical medicine
Myocardial infarction
lcsh:Science
Singapore
Multidisciplinary
Ejection fraction
medicine.diagnostic_test
biology
Age Factors
Middle Aged
Prognosis
Hospitalization
Treatment Outcome
Cardiology
Female
Interventional cardiology
medicine.medical_specialty
Article
03 medical and health sciences
Percutaneous Coronary Intervention
Asian People
Internal medicine
medicine
Humans
cardiovascular diseases
Killip class
Aged
Heart Failure
business.industry
lcsh:R
Percutaneous coronary intervention
medicine.disease
Troponin
Survival Analysis
030104 developmental biology
Risk factors
Heart failure
biology.protein
lcsh:Q
Myocardial infarction diagnosis
business
030217 neurology & neurosurgery
Zdroj: Scientific Reports, Vol 9, Iss 1, Pp 1-14 (2019)
Scientific Reports
ISSN: 2045-2322
Popis: We aimed to identify independent predictors of cardiac mortality and hospitalization for heart failure (HHF) from a real-world, multi-ethnic Asian registry [the Singapore Myocardial Infarction Registry] of ST-segment elevation myocardial infarction (STEMI) patients treated by primary percutaneous coronary intervention. 11,546 eligible STEMI patients between 2008 and 2015 were identified. In-hospital, 30-day and 1-year cardiac mortality and 1-year HHF rates were 6.4%, 6.8%, 8.3% and 5.2%, respectively. From the derivation cohort (70% of patients), age, Killip class and cardiac arrest, creatinine, hemoglobin and troponin on admission and left ventricular ejection fraction (LVEF) during hospitalization were predictors of in-hospital, 30-day and 1-year cardiac mortality. Previous ischemic heart disease (IHD) was a predictor of in-hospital and 30-day cardiac mortality only, whereas diabetes was a predictor of 1-year cardiac mortality only. Age, previous IHD and diabetes, Killip class, creatinine, hemoglobin and troponin on admission, symptom-to-balloon-time and LVEF were predictors of 1-year HHF. The c-statistics were 0.921, 0.901, 0.881, 0.869, respectively. Applying these models to the validation cohort (30% of patients) showed good fit and discrimination (c-statistic 0.922, 0.913, 0.903 and 0.855 respectively; misclassification rate 14.0%, 14.7%, 16.2% and 24.0% respectively). These predictors could be incorporated into specific risk scores to stratify reperfused STEMI patients by their risk level for targeted intervention.
Databáze: OpenAIRE
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