Prevalence and Risk Factors of In-Hospital Mortality of ST Elevation Myocardial Infarction (STEMI) Patients in Bekasi Regency General Hospital in 2021

Abstract

Background: Acute Coronary Syndrome (ACS) is a major cardiovascular problem and has been one of the leading death in the world. ST-Elevation Myocardial Infarction (STEMI) is an indicator of total coronary artery occlusion which requires revascularization to restore the blood flow and myocardial reperfusion using fibrinolytic agents or primary Percutaneous Coronary Intervention (PCI). Early treatment showed better outcomes and reduced in-hospital mortality in ACS patients.
 Aims: To determine the prevalence of Acute Coronary Syndrome (ACS) patients and the risk factors of in-hospital mortality of ST-Elevation Myocardial Infarction (STEMI) patients at Bekasi Regency General Hospital in 2021.
 Place and Duration of Study: Cardiology Department and Emergency Room Unit in Bekasi Regency General Hospital, December 2021 to March 2022
 Methods: This study is a descriptive cross-sectional study using secondary data (medical records) which included all the patients over 35 years old that admitted through the ER from January to December 2021 with complaints including chest pain or shortness of breath which were later hospitalized. The final sample used in this study is 117 subjects.
 Results: There were 117 cases of ACS in 2021. They were 14% STEMI, 15% Non-ST Elevation Myocardial Infarction (NSTEMI), and 71% Unstable Angina Pectoris (UAP). Most patients were male (54%), and aged <65 years old (85%). The in-hospital mortality was 19% STEMI, 17% NSTEMI, and 12% UAP. Among 16 STEMI patients, 81% were male and 94% were aged <65 years old. There were 69% who came to the emergency room <12 hours and only 50% underwent fibrinolytic.
 Conclusion: The risk factors of in-hospital mortality of STEMI patients were 40% late onset, 23% anterior STEMI, 20% hypertension, 60% diabetes mellitus, 50% chronic kidney disease, 33% tachycardia, and 100% Killip III.