Assessing the Short-term Survival of Patients with Acute Myocardial Infarction and Some of its Predicting Factors in Dezful during 2018-2019

Document Type : Original Article

Authors

1 Assistant Professor of Echocardiography, Department of Cardiology, School of Medicine, Dezful University of Medical Sciences, Dezful, Iran.

2 Student of General Practitioner, School of Medicine, Dezful University of Medical Sciences, Dezful, Iran

3 Associate Professor of Epidemiology, School of Medicine, Dezful University of Medical Sciences, Dezful, Iran.

10.32592/JSMJ.23.1.32

Abstract

Background and Objectives Cardiovascular diseases are the leading cause of death and the most important cause of disability in most countries. This study aimed to investigate short-term survival (28 days) in patients with acute myocardial infarction (AMI) and to determine some predictive factors of short-term survival in these patients. Subjects and Methods This study was a retrospective cohort study conducted on 260 patients with AMI in Ganjavian Hospital, a referral hospital in Dezful, Iran, during 2018-2019. Life table and Kaplan Meier analyses were used for the assessment of short-term survival rate. Log rank, Wilcoxon tests, and Cox multivariate regression were used to compare survival functions and determine the predictive factors of short-term survival. Results The mean age of the patients was 57.91 ± 10.76 years, and 193 (74.23%) were male. The survival rate was 90% on the 28th day. In Cox regression, the risk of death in women was higher than that in men (HR=1.82, 95% CI: 1.08-3.47). Also, the risk of death had a statistically significant association with diabetes status (HR=2.87,95% CI: 1.21-6.78), history of ACS (HR=3.03, CI95%: 1.32-6.92), EF<30 (HR=5.24, CI95%: 1.68-9.30), thrombolytic drugs (HR=1.84, CI95%: 1.10-3.57), arrhythmia (HR=6.98,95% CI: 2.31-21.08) and anterior MI (HR=1.67, CI95%: 1.27-2.79). Conclusion In the AMI patients, the 28-day survival rate was about 90%, which was the highest risk of death in the first 8 days after an AMI. The factors of sex, diabetes status, history of ACS, EF, thrombolytic drugs, arrhythmia, and location of AMI were associated with the survival of patients. Therefore, timely and appropriate follow-up of treatment, especially in high-risk groups, plays an important role in increasing survival in patient with AMI.

Keywords

Main Subjects

References

[1] Hessami A, Shamshirian A, Heydari K, Pourali F, Alizadeh-Navaei R, Moosazadeh M, Abrotan S, Shojaie L, Sedighi S, Shamshirian D, Rezaei N. Cardiovascular diseases burden in COVID-19: Systematic review and meta-analysis. The American journal of emergency medicine. 2021 Aug 1;46:382-91. [10. 1016/j.ajem.2020.10.022] [PMID]
[2] Prabhakaran D, Jeemon P, Sharma M, Roth GA, Johnson C, Harikrishnan S, Gupta R, Pandian JD, Naik N, Roy A, Dhaliwal RS. The changing patterns of cardiovascular diseases and their risk factors in the states of India: the Global Burden of Disease Study 1990–2016. The Lancet Global Health. 2018 Dec 1;6(12):e1339-51. [10.1016/S2214-109X(18)30407-8] [PMID]
[3] Countdown NC. NCD Countdown 2030: worldwide trends in non-communicable disease mortality and progress towards Sustainable Development Goal target 3.4. Lancet (London, England). 2018 Sep 22;392(10152):1072-88. [10.1016/S0140-6736(18)31992-5] [PMID]
[4] Masaebi F, Salehi M, Kazemi M, Vahabi N, Azizmohammad Looha M, Zayeri F. Trend analysis of disability adjusted life years due to cardiovascular diseases: results from the global burden of disease study 2019. BMC Public Health. 2021 Dec;21:1-3. [10.1186/s12889-021-11348-w] [PMID]
[5] Sarrafzadegan N, Mohammmadifard N. Cardiovascular disease in Iran in the last 40 years: prevalence, mortality, morbidity, challenges and strategies for cardiovascular prevention. Archives of Iranian medicine. 2019 Apr 1;22(4):204-10. [PMID]
[6] Tran P, Tran L, Tran L. A cross-sectional analysis of binge drinking levels in US myocardial infarction survivors. Heart & Lung. 2021 May 1;50(3):461-4. [10.1016/j.hrtlng.2020.10.003] [PMID]
[7] Chew DP, Huynh LT, Liew D, Astley C, Soman A, Brieger D. Potential survival gains in the treatment of myocardial infarction. Heart. 2009 Nov 15;95(22):1844-50. [10.1136/hrt. 2009.174276] [PMID]
[8] Hafshejani AM, Baradaran H, Sarrafzadegan N, AsadiLari M, Ramezani A, Hosseini SH, Hafshejani FA. Predicting factors of short-term survival in patients with acute myocardial infarction in Isfahan using a cox regression model. Iranian Journal of Epidemiology. 2012 Jan 1;8(2):39-47.
[9] Bravata DM, Daggy J, Brosch J, Sico JJ, Baye F, Myers LJ, Roumie CL, Cheng E, Coffing J, Arling G. Comparison of risk factor control in the year after discharge for ischemic stroke versus acute myocardial infarction. Stroke. 2018 Feb;49(2):296-303. [10.1161/STROKEAHA.117.017142] [PMID]
[10] Salah HM, Minhas AM, Khan MS, Khan SU, Ambrosy AP, Blumer V, Vaduganathan M, Greene SJ, Pandey A, Fudim M. Trends in hospitalizations for heart failure, acute myocardial infarction, and stroke in the United States from 2004 to 2018. American heart journal. 2022 Jan 1;243:103-9. [10.1016/j.ahj.2021. 09.009] [PMID]
[11] Hochman JS, Sleeper LA, Webb JG, Dzavik V, Buller CE, Aylward P, Col J, White HD, SHOCK Investigators F. Early revascularization and long-term survival in cardiogenic shock complicating acute myocardial infarction. Jama. 2006 Jun 7; 295(21):2511-5. [10.1001/jama.295.21.2511] [PMID]
[12] Skinner JS, Staiger DO, Fisher ES. Is Technological Change In Medicine Always Worth It? The Case Of Acute Myocardial
Infarction: Waste and inefficiency are not inevitable by-products of technological growth. Health affairs. 2006;25 (Suppl1):W34-47. [10.1377/hlthaff.25.w34] [PMID]
[13] Tavazzi L. Clinical epidemiology of acute myocardial infarction. American Heart Journal. 1999 Aug 1;138(2):S48-54. [10.1016/ s0002-8703(99)70320-0] [PMID]
[14] World Health Organization. WHO MONICA Project: MONICA manual. InWHO MONICA Project: MONICA manual 1990. [15] Mohammadian Hafshejani A, Baradaran attar Moghaddam HR, et al. Evaluation of short-term survival of patients with acute myocardial infarction and the differences between the sexes in Isfahan and Najaf Abad between (1378–1387). Razi Journal of Medical Sciences. 2012 May 10;19(95):25-34.
[16] Champney KP, Frederick PD, Bueno H, Parashar S, Foody J, Merz CN, Canto JG, Lichtman JH, Vaccarino V. The joint contribution of sex, age and type of myocardial infarction on hospital mortality following acute myocardial infarction. Heart. 2009 Jun 1;95(11):895-9. [10.1136/hrt.2008.155804] [PMID]
[17] Mehta LS, Beckie TM, DeVon HA, Grines CL, Krumholz HM, Johnson MN, Lindley KJ, Vaccarino V, Wang TY, Watson KE, Wenger NK. Acute myocardial infarction in women: a scientific statement from the American Heart Association. Circulation. 2016 Mar 1;133 (9):916-47. [10.1161/CIR.0000000000000351] [PMID] [18] Bueno H, Vidán MT, Almazán A, López-Sendón JL, Delcán JL. Influence of sex on the short-term outcome of elderly patients with a first acute myocardial infarction. Circulation. 1995 Sep 1;92(5):1133-40. [10.1161/01.cir.92.5.1133] [PMID] [19] Anderson RD, Pepine CJ. Gender differences in the treatment for acute myocardial infarction: bias or biology?. Circulation. 2007 Feb 20;115(7):823-6. [10.1161/CIRCULATIONAHA.106. 685859] [PMID] [20] Hayıroğlu Mİ, Keskin M, Uzun AO, Yıldırım Dİ, Kaya A, Çinier G, Bozbeyoğlu E, Yıldırımtürk Ö, Kozan Ö, Pehlivanoğlu S. Predictors of in-hospital mortality in patients with ST-segment elevation myocardial infarction complicated with cardiogenic shock. Heart, Lung and Circulation. 2019 Feb 1;28(2):237-44. [10.1016/j.hlc.2017.10.023] [PMID] [21] Fanta K, Daba FB, Tegene E, Melaku T, Fekadu G, Chelkeba L. Management quality indicators and in-hospital mortality among acute coronary syndrome patients admitted to tertiary hospitals in Ethiopia: prospective observational study. BMC emergency medicine. 2021 Dec;21(1):1-9. [10.1186/s12873-021-00433-3] [PMID] [22] Valizadeh A, Soltanabadi S, Koushafar S, Rezaee M, Jahankhah R. Comparison of QT dispersion in patients with ST elevation acute myocardial infarction (STEMI) before and after treatment by streptokinase versus primary percutaneous coronary intervention (PCI). BMC Cardiovascular Disorders. 2020 Dec;20(1):1-8. [10.1186/s12872-020-01767-9] [PMID] [23] Bawaskar HS, Bawaskar PH, Bawaskar PH. Preintensive care: thrombolytic (streptokinase or tenecteplase) in ST elevated acute myocardial infarction at peripheral hospital. Journal of Family Medicine and Primary Care. 2019 Jan;8(1):62. [10. 4103/jfmpc.jfmpc_297_18] [PMID] [24] Amani FI, Hajizadeh EB, Hoseinian F. Survival rate in MI patients. Koomesh. 2008 Feb 10;9(2):131-8.
[25] Ouhoummane N, Abdous B, Emond V, Poirier P. Impact of
Jundishapur
Journal of Medical Sciences
March & April 2024. Vol 23. No 1
Saadatifar H, et al. Short-term Survival of Patients with Acute Myocardial Infarction. JSMJ. 2024; 23(1):32-43
43
diabetes and gender on survival after acute myocardial infarction in the Province of Quebec, Canada--a population-based study. Diabet Med 2009 Jun;26(6):609-616. [10.1111/ j.1464-5491.2009.02740.x] [PMID]
[26] Kumler T, Gislason GH, Kober L, Torp-Pedersen C. Diabetes is an independent predictor of survival 17 years after myocardial infarction follow-up of the TRACE registry. Cardiovasc Diabetol 2010;9: 22. [10.1186/1475-2840-9-22] [PMID] [27] Firdaus Aziz ، Sorayya Malek, et al. Short- and long-term mortality prediction after an acute ST-elevation myocardial infarction (STEMI) in Asians: A machine learning approach 2021 Aug 2;16(8):e0254894. [10.1371/journal.pone.0254894] [PMID]
[28] Antmon EM, Braunwald E. Acute myocardial Infarction. In: Braunwald E, Zipes P, libby P, Bonow O, Braunwald Heart Disease. 8th ed. Philadelphia: W.B. Saunders; 2008. Vol 2.p.1141-1167.
[29] Popma J, Kuntz R, Baim D. Percotaneus coronary and intervention. In: Braunwald E, Zipes DP, Libby P. Heart Disease: A textbook of cardiovascular medicine. 8th ed. Philadelphia: W.B. Saunders; 2008.p.1367-85. [30] Greig D, Corbalan R, Castro P, Campos P, Lamich R, Yovaniniz P. Mortality of patients with ST-elevation acute myocardial infarction treated with primary angioplasty or thrombolysis. Revista Medica de Chile. 2008 Sep 1;136(9):1098-106. [PMID
Jundishapur Scientific Medical Journal
Volume 23, Issue 1 - Serial Number 148
March and April 2024
Pages 32-43

Files

History

  • Receive Date: 29 December 2023
  • Revise Date: 09 March 2024
  • Accept Date: 17 March 2024

Share

How to cite

Statistics