Analysis of the clinical characteristics, management, and causes of death in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention from 2005 to 2014

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6 Citations (Scopus)

Abstract

It is unknown whether there has been any change in the causes of death for acute ST-segment elevation myocardial infarction (STEMI) in the era of aggressive reperfusion. We analyzed the direct causes of in-hospital death in patients with STEMI treated with primary percutaneous coronary intervention (PCI) in a tertiary referral center over the past 10 years. We retrospectively analyzed 878 STEMI patients treated with primary PCI in our hospital between January 2005 and December 2014. There were no significant changes in the age and sex of patients, but the prevalence of hypertension and smoking decreased. STEMI severity increased with more patients in Killip classification > 2. The number of out-ofhospital cardiac arrest events also increased over the 10 years. Symptom onset-to-door time did not change in the 10year study period. The care quality was improved with shorter door-to-balloon time for primary PCI and increased use of dual antiplatelet therapy. The all-cause in-hospital mortality was 9.1%, which did not vary over the 10 years. Multivariable analysis showed that Killip classification > 2 was the most important determinant of death. Cardiogenic shock was the major cause of cardiovascular death. There was an increase in non-cardiovascular causes of death in the most recent 3 years, with infection being a major problem. Despite improvement in care quality for STEMI, the in-hospital mortality did not decrease in this tertiary referral center over these 10 years due to increased disease severity and non-cardiovascular causes of death.

Original languageEnglish
Pages (from-to)541-546
Number of pages6
JournalInternational Heart Journal
Volume57
Issue number5
DOIs
Publication statusPublished - 2016 Jan 1

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Percutaneous Coronary Intervention
Cause of Death
Quality of Health Care
Hospital Mortality
Tertiary Care Centers
Cardiogenic Shock
Heart Arrest
Reperfusion
Smoking
ST Elevation Myocardial Infarction
Hypertension
Infection

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Analysis of the clinical characteristics, management, and causes of death in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention from 2005 to 2014",
abstract = "It is unknown whether there has been any change in the causes of death for acute ST-segment elevation myocardial infarction (STEMI) in the era of aggressive reperfusion. We analyzed the direct causes of in-hospital death in patients with STEMI treated with primary percutaneous coronary intervention (PCI) in a tertiary referral center over the past 10 years. We retrospectively analyzed 878 STEMI patients treated with primary PCI in our hospital between January 2005 and December 2014. There were no significant changes in the age and sex of patients, but the prevalence of hypertension and smoking decreased. STEMI severity increased with more patients in Killip classification > 2. The number of out-ofhospital cardiac arrest events also increased over the 10 years. Symptom onset-to-door time did not change in the 10year study period. The care quality was improved with shorter door-to-balloon time for primary PCI and increased use of dual antiplatelet therapy. The all-cause in-hospital mortality was 9.1{\%}, which did not vary over the 10 years. Multivariable analysis showed that Killip classification > 2 was the most important determinant of death. Cardiogenic shock was the major cause of cardiovascular death. There was an increase in non-cardiovascular causes of death in the most recent 3 years, with infection being a major problem. Despite improvement in care quality for STEMI, the in-hospital mortality did not decrease in this tertiary referral center over these 10 years due to increased disease severity and non-cardiovascular causes of death.",
author = "Po-Tseng Lee and Ting-Hsing Chao and Huang, {Ya Ling} and Sheng-Hsiang Lin and Wang, {Wei Ming} and Wen-Huang Li and Chen-Wei Huang and Cheng-Han Lee and Zi-Yi Chen and Chih-Chan Lin and Ping-Yen Liu and Shih-Hung Chan and Yen-Wen Liu and Wei-Chuan Tsai and Lin, {Li Jen} and Liang-Miin Tsai and Yi-Heng Li",
year = "2016",
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T1 - Analysis of the clinical characteristics, management, and causes of death in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention from 2005 to 2014

AU - Lee, Po-Tseng

AU - Chao, Ting-Hsing

AU - Huang, Ya Ling

AU - Lin, Sheng-Hsiang

AU - Wang, Wei Ming

AU - Li, Wen-Huang

AU - Huang, Chen-Wei

AU - Lee, Cheng-Han

AU - Chen, Zi-Yi

AU - Lin, Chih-Chan

AU - Liu, Ping-Yen

AU - Chan, Shih-Hung

AU - Liu, Yen-Wen

AU - Tsai, Wei-Chuan

AU - Lin, Li Jen

AU - Tsai, Liang-Miin

AU - Li, Yi-Heng

PY - 2016/1/1

Y1 - 2016/1/1

N2 - It is unknown whether there has been any change in the causes of death for acute ST-segment elevation myocardial infarction (STEMI) in the era of aggressive reperfusion. We analyzed the direct causes of in-hospital death in patients with STEMI treated with primary percutaneous coronary intervention (PCI) in a tertiary referral center over the past 10 years. We retrospectively analyzed 878 STEMI patients treated with primary PCI in our hospital between January 2005 and December 2014. There were no significant changes in the age and sex of patients, but the prevalence of hypertension and smoking decreased. STEMI severity increased with more patients in Killip classification > 2. The number of out-ofhospital cardiac arrest events also increased over the 10 years. Symptom onset-to-door time did not change in the 10year study period. The care quality was improved with shorter door-to-balloon time for primary PCI and increased use of dual antiplatelet therapy. The all-cause in-hospital mortality was 9.1%, which did not vary over the 10 years. Multivariable analysis showed that Killip classification > 2 was the most important determinant of death. Cardiogenic shock was the major cause of cardiovascular death. There was an increase in non-cardiovascular causes of death in the most recent 3 years, with infection being a major problem. Despite improvement in care quality for STEMI, the in-hospital mortality did not decrease in this tertiary referral center over these 10 years due to increased disease severity and non-cardiovascular causes of death.

AB - It is unknown whether there has been any change in the causes of death for acute ST-segment elevation myocardial infarction (STEMI) in the era of aggressive reperfusion. We analyzed the direct causes of in-hospital death in patients with STEMI treated with primary percutaneous coronary intervention (PCI) in a tertiary referral center over the past 10 years. We retrospectively analyzed 878 STEMI patients treated with primary PCI in our hospital between January 2005 and December 2014. There were no significant changes in the age and sex of patients, but the prevalence of hypertension and smoking decreased. STEMI severity increased with more patients in Killip classification > 2. The number of out-ofhospital cardiac arrest events also increased over the 10 years. Symptom onset-to-door time did not change in the 10year study period. The care quality was improved with shorter door-to-balloon time for primary PCI and increased use of dual antiplatelet therapy. The all-cause in-hospital mortality was 9.1%, which did not vary over the 10 years. Multivariable analysis showed that Killip classification > 2 was the most important determinant of death. Cardiogenic shock was the major cause of cardiovascular death. There was an increase in non-cardiovascular causes of death in the most recent 3 years, with infection being a major problem. Despite improvement in care quality for STEMI, the in-hospital mortality did not decrease in this tertiary referral center over these 10 years due to increased disease severity and non-cardiovascular causes of death.

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