Predictors of In-Hospital Mortality in Korean Patients with Acute Myocardial Infarction

Abstract

Acute myocardial infarction (AMI) is a fatal cardiovascular disease, and mortality is relatively high; therefore, integrated assessment is necessary for its management. There are several risk predictive models, but treatment trends have changed due to newly introduced medications and the universal use of percutaneous coronary intervention (PCI). The author aimed to find out predictive factors of in-hospital mortality in Korean patients with AMI. A group of 13,104 patients with AMI enrolled in the Korea Acute Myocardial Infarction Registry-National Institute of Health (KAMIR-NIH) registry were divided into two groups. One was a derivation group for evaluating mortality prediction; the other was a validation group for the application of risk prediction. In-hospital mortality was 4.2% (n=552). With hierarchical and stepwise multivariate analyses, nine factors were shown to predict in-hospital mortality for Korean patients with AMI. These were 1) being over 65 years of age, 2) high Killip class over II, 3) hyperglycemia over 180 mg/dl, 4) tachycardia over 100/min, 5) serum creatinine over 1.5 mg/dl, 6) atypical chest pain, 7) low systolic blood pressure under 90 mmHg, 8) low Thrombolysis In Myocardial Infarction (TIMI) flow (TIMI 0-II) before PCI and 9) low TIMI flow (TIMI 0-II) after PCI. The validation group showed a predictive power of 88.3%. Old age, high Killip class, hyperglycemia, tachycardia, renal dysfunction, atypical chest pain, low systolic blood pressure, and low TIMI flow are important risk factors of in-hospital mortality in Korean patients with AMI.

Predictors of Cardiac Arrest in Patients with Acute Myocardial Infarction in Singkawang City

“…The Killip classification is an important predictor of the risk of death in patients with acute myocardial infarction including cardiac arrest during hospitalization. The higher the Killip classification, the higher the risk of cardiac arrest (Yang et al, 2019). In this study, most of the respondents who experienced cardiac arrest were respondents with class Killip 4 totaling 12 people.…”

“…This finding was reinforced in previous studies that gender differences do play an important role in the pathophysiology of AMI, but coronary plaque rupture and acute thrombosis formation are common in both men and women. The difference is that in women, AMI often occurs at an older age but has a higher mortality than men (Yang et al, 2019).…”

“…The Killip class variable has the highest coefficient (B) of 1.104 so it is the most influential variable in this study. This factor is a strong predictor associated with the cause of death in hospital (Yang et al, 2019) and is an important independent predictor of the risk of death in acute myocardial infarction patients including cardiac arrest during hospitalization (de Mello et al, 2014).…”

Elevated shock index and modified shock index are associated with mortality and major adverse cardiac events in patients with acute myocardial infarction: A systematic review and meta-analysis

“…Thus, the use of SI and MSI in AMI patients is thought to be relatively reasonable, as each component of SI and MSI, including heart rate (HR), systolic blood pressure (SBP), and mean arterial pressure (MAP), was previously known to be an independent risk factor of mortality in patients with AMI. 3,4,[32][33][34][35] Although there are several plausible explanations for the nature of such an association, the precise pathophysiological relationship between SI, MSI, and adverse outcomes remains undecipherable. To begin, it is widely known that AMI patients generally experience sympathetic nervous system hyperactivity, which regulates HR and SBP.…”

Ginsenoside Rd Promotes Cardiac Repair After Myocardial Infarction by Modulating Monocytes/Macrophages Subsets Conversion

“…p < 0.05 was considered statistically significant. According to the literature, 27 sufficient statistical sample size was designed in the experiment. Randomization and blinding strategies were used whenever possible.…”