The most important predictors in hospital mortality of patients with acute ST elevation myocardial infarction (STEMI) - using Yazd Cardiovascular Diseases Registry, YCDR data

Abstract

Abstract Background One of the consequences of coronary heart diseases (CAD) is a heart attack, which can sometimes lead to death. In Iran, as well as in most West Asian countries, cardiovascular diseases are the leading cause of death, accounting for 46% of total mortality. This study aims to estimate and identify in hospital mortality predictors or prognostic factors for patients with acute ST elevation myocardial infarction (STEMI). Methods This study utilized data from the Yazd Cardiovascular Diseases Registry (YCDR), which is a registry of inpatient ischemic heart disease in Yazd province, Iran. Logistic Regression was used to analyze and adjust for confounding. Variables that were not significant in the univariate analysis (P_value > 0.10) were discarded, and the remaining variables were entered into multivariable analysis. Variables with P_value < 0.05 were retained in the model, while others were discarded. Results The study included 1,861 patients with STEMI. Among them, 105 (5.7%) individuals died during admission the hospital. After multivariable logistic regression, the following variables were identified as prognostic factors for in-hospital mortality of STEMI: having a history of CVA (OR: 23.1, 95% CI: 19.2–28.3), lower ejection fraction (OR: 8.6, 95% CI: 7.2–9.8), lower HDL cholesterol (OR: 1.1, 95% CI: 1.01–2.3), being single (OR: 1.4, 95% CI: 1.2–3.1), and lower hemoglobin (OR: 1.4, 95% CI: 1.3–2.9). Conclusion We evaluated the most important predictors of in-hospital mortality of STEMI and found that lower ejection fraction, lower hemoglobin levels, having a history of CVA, being unmarried, and low HDL cholesterol levels are important prognostic factors. Health policy in STEMI management must consider these factors to improve hospital prognosis.