Independent predictors of six-month mortality in patients with non-ST-elevation myocardial infarction (NSTEMI) = Neodvisni napovedni dejavniki šest mesečne umrljivosti pri bolnikih s srčnim infarktom brez dviga veznice ST (NSTEMI)
Sinkovič, Andreja ; Koren Krajnc, Metka
The incidence and prevalence of non-ST-elevation myocardial infarction (NSTEMI) is rising. In-hospital mortality of patients with ACS declined significantly in the last decade. In NSTEMI patients, ...in-hospital mortality declined from 2.9 % to 2.2 % and 6-month mortality from 4.9 % to 3.3 %. The most important well-known predictors of early and late mortality include the troponin level, admission heart failure and ECG changes. Early risk stratification making in diagnosis and treatment. Our aim was to evaluate early independent predictors of 6-month mortality in patients with NSTEMI. Methods. This observational prospective monocentric study included 100 patients with NSTEMI who were admitted to the Department of Medical Intensive Care. They had the chest pain, increased troponin T levels and either ST-segment depression >/- mV and/or T wave inversion >/- 0.1 mV and/or pathological Q wave suspicious of previous infarction. After initial medical therapy, percutaneous coronary intervations (PCI) were performed within the first 48 hours in the case of recurrent chest pain and/or rhytmic and/or hemodynamic instability. Results. 6-month mortality was 10 %. Between nonsurvivors and survivors at 6 month, significant differences were observed in physical activity, admission cholesterol levels, in-hospital cardiogenic shock, pulmonary edema and peak troponin T lvel. The most significant independent predictor of 6-month mortality by multivariate Cox regression was cardiogenic shock in-hospital (OR 0.019,95 % Cl 0.003 to 0.124, p < 0.001). Conclusions. In our patients with NSTEMI, the most significant independent predictor of 6-month mortality was in-hospital cardiogenic shock.
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