Factors associated with poor clinical outcomes of ST-elevation myocardial infarction in patients with door-to-balloon time &lt;90 minutes

Tsukui, Takunori; Sakakura, Kenichi; Taniguchi, Yousuke; Yamamoto, Kei; Seguchi, Masaru; Jinnouchi, Hiroyuki; Wada, Hiroshi; Fujita, Hideo

doi:10.1371/journal.pone.0241251

Cited by 11 publications

(7 citation statements)

References 46 publications

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“…24) The initial thrombolysis in myocardial infarction (TIMI) flow grade, final TIMI flow grade, and TIMI thrombus grade were recorded from coronary angiography. 11,25) Statistical analysis: Data are expressed as the mean ± SD or percentage. Categorical variables are presented as numbers (percentage) and were compared using Fisher's exact test.…”

Section: Methodsmentioning

confidence: 99%

“…10) It is also known that Killip class !2 is associated with favorable clinical outcomes in patients with AMI. 11,12) However, the clinical outcomes in patients with Killip class 3 were not consistent among different reports, [13][14][15] suggesting that the severity of Killip class 3 varies widely from simple pulmonary edema to pulmonary edema complicated with a pre-shock state. Moreover, the clinical factors associated with poor clinical outcomes have not been sufficiently investigated in AMI patients with Killip class 3.…”

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confidence: 94%

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Factors Associated with In-Hospital Death in Patients with Killip Class 3 Acute Myocardial Infarction

et al. 2021

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The clinical outcomes in acute myocardial infarction (AMI) patients with Killip class 3 are often inconsistent with those in the literature, and the factors associated with poor outcomes have not been sufficiently investigated. The purpose of this study was to identify factors associated with in-hospital death in AMI patients with Killip class 3. We included 205 AMI patients with Killip class 3, and divided them into a survived group (n = 189) and in-hospital death group (n = 16). The primary objective was to identify factors associated with inhospital death using multivariate analysis. Age was significantly younger in the survived group than in the inhospital death group (73.1 ± 11.2 versus 83.2 ± 6.2 years, P < 0.001). Systolic blood pressure (SBP) was significantly higher in the survived group than in the in-hospital death group (150.0 ± 31.2 versus 124.8 ± 25.3 mmHg, P = 0.002). The prevalence of TIMI thrombus grade "2 was significantly greater in the in-hospital death group than in the survived group (56.3 versus 22.2%, P = 0.005). In multivariate logistic regression analysis, in-hospital death was significantly associated with age [odds ratio (OR) 1.168, 95% confidence interval (CI) 1.061-1.287, P = 0.002] and TIMI thrombus grade "2 (versus !1: OR 5.743, 95% CI 1.717-19.214, P = 0.005), and inversely associated with SBP on admission (per 10 mmHg increase: OR 0.764, 95% CI 0.613-0.953, P = 0.017). In conclusion, in-hospital death was associated with age and coronary thrombus burden, and was inversely associated with SBP on admission in patients with Killip class 3. It may be important to recognize these high risk features to improve the clinical outcomes of patients with Killip class 3.

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Section: Methodsmentioning

confidence: 99%

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confidence: 94%

Factors Associated with In-Hospital Death in Patients with Killip Class 3 Acute Myocardial Infarction

et al. 2021

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“…One of the factors that decreased mortality of STEMI patients is early PCI that suggested that door to balloon time <90 min. [ 38 39 40 ] Our study considered time interval between arrival at PCI hospital and reperfusion therapy. We found longer mean of this time in our patients who died.…”

Section: Discussionmentioning

confidence: 99%

Predictors of mortality for patients with ST-elevation myocardial infraction after 2-year follow-up: A ST-elevation myocardial infarction cohort in Isfahan study

Sadeghi

Jamalian²,

Roohafza³

et al. 2022

Adv Biomed Res

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Background: Mortality of ST-elevation myocardial infarction (STEMI) patients is increasing in world. This study defines predictors of mortality in patients who have STEMI. Materials and Methods: This study was a part of the ST-elevated myocardial infarction cohort study in Isfahan conducted on 876 acute myocardial infarction (MI) followed for 2 years that 781 patient entered. The effect of predictors of mortality includes demographic, physiological, and clinical characterizes compared in two groups alive and died patients. MACE was defined as nonfatal MI, nonfatal stroke, and atherosclerosis cardiovascular disease-related death was recorded. Univariate and multiple logistic regression analyses were performed. All analyses performed using SPSS 20.0. P < 0.05 considered statistically significant. Results: A total 781 patients, 117 (13%) that 72 (8.5%) was in-hospital died. The mean (standard deviation) age of the patients was 60.92 (12.77) years and 705 (81.3%) patients were males. Significant factors that affected mortality on analysis of demographic and physiological parameters were age ( P < 0.001), sex ( P = 0.004), transfusion ( P = 0.010), STEMI type ( P < 0.001), number epicardial territories >50% ( P = 0.001), ventilation options ( P < 0.001), smoker ( P = 0.003), and diabetes ( P = 0.026). Significant clinical factors affected mortality were ejection fraction (EF) ( P < 0.001), creatinine ( P < 0.001), hemoglobin ( P < 0.001), low-density lipoprotein-cholesterol (LDL-C) ( P = 0.019), and systolic blood pressure ( P < 0.001). Multiple logistics regression model definition significant predictors for mortality were age ( P < 0.001), heart rate (HR) ( P = 0.007), EF (0.039), LDL-C ( P = 0.002), and preangia ( P = 0.022). Conclusion: The set of factors can increase or decrease mortality in these patients. Significant predictors of mortality STEMI patients by 2-year follow up were age, HR, EF, LDL-C, and preangia. It seems that more articles need to be done in different parts of Iran to confirm the results.

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“…We also calculated the estimated glomerular filtration rate (eGFR) using serum creatinine (Cr), age, weight, and gender according to the following formula: eGFR 194 Cr 1.094 age 0.287 (male), or eGFR 194 Cr 1.094 age 0.287 0.739 (female) 21) . The initial thrombolysis in myocardial infarction (TIMI) flow grade and final TIMI flow grade were recorded from coronary angiography 22) .…”

Section: Introductionmentioning

confidence: 99%

Association of Asymptomatic Low Ankle–Brachial Index with Long-Term Clinical Outcomes in Patients after Acute Myocardial Infarction

Ban

Sakakura

Jinnouchi

et al. 2022

JAT

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Peripheral arterial disease (PAD) is the well-known risk factor for cardiovascular events. Although low ankle-brachial index (ABI) is recognized as a risk factor in general population, low ABI without any symptoms of PAD has not been established as a prognostic marker in patients with acute myocardial infarction (AMI) yet. The purpose of this retrospective study was to examine whether asymptomatic low ABI was associated with longterm clinical outcomes in AMI patients without treatment history of PAD.Methods: We included 850 AMI patients without a history of PAD and divided them into the preserved ABI (ABI ≥ 0.9) group (n 760) and the reduced ABI (ABI 0.9) group (n 90) on the basis of the ABI measurement during the hospitalization. The primary endpoint was the major adverse cardiovascular events (MACE) defined as the composite of all-cause death, non-fatal myocardial infarction, and hospitalization for heart failure.Results: During the median follow-up duration of 497 days (Q1: 219 days to Q3: 929 days), a total of 152 MACE were observed. The Kaplan-Meier curves showed that MACE were more frequently observed in the reduced ABI group than in the preserved ABI group (p 0.001). The multivariate COX hazard analysis revealed that reduced ABI was significantly associated with MACE (hazard ratio 2.046, 95% confidence interval 1.344-3.144, p 0.001) after controlling confounding factors. Conclusions:Reduced ABI was significantly associated with long-term adverse events in AMI patients without a history of PAD. Our results suggest the usefulness of ABI as a prognostic marker in AMI patients irrespective of symptomatic PAD.events 4,5) . Moreover, AMI patients with left ventricular dysfunction would definitely have poor clinical outcomes 6) . Therefore, AMI patients with residual ischemia or left ventricular dysfunction should be closely followed up by cardiologists. However, since AMI patients with unrecognized risk factors may miss the opportunity to be closely followed up, it would be clinically important to find those unrecognized risk factors to improve long-term clinical outcomes in AMI patients.Peripheral arterial disease (PAD), especially symptomatic PAD, is the well-known risk factor for Copyright©2021 Japan Atherosclerosis Society This article is distributed under the terms of the latest version of CC BY-NC-SA defined by the Creative Commons Attribution License.

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Factors associated with poor clinical outcomes of ST-elevation myocardial infarction in patients with door-to-balloon time <90 minutes

Cited by 11 publications

References 46 publications

Factors Associated with In-Hospital Death in Patients with Killip Class 3 Acute Myocardial Infarction

Factors Associated with In-Hospital Death in Patients with Killip Class 3 Acute Myocardial Infarction

Predictors of mortality for patients with ST-elevation myocardial infraction after 2-year follow-up: A ST-elevation myocardial infarction cohort in Isfahan study

Association of Asymptomatic Low Ankle–Brachial Index with Long-Term Clinical Outcomes in Patients after Acute Myocardial Infarction

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