Abstract 15254: Temporal Assessment of Clinical Outcomes in Patients With ST-Elevation Myocardial Infarction and Non-ST-Elevation Myocardial Infarction
Kyung Hoon Cho, Seok Oh, Yongwhan Lim, Joon Ho Ahn, Seung Hun Lee, Dae Young Hyun, Min Chul Kim, Doo Sun Sim, Young Joon Hong, Juhan kim, Young Keun Ahn, Jang Hoon Lee, Chang-hwan Yoon, Sang Rok Lee, Joo-Yong Hahn, Jin-Ok Jeong, Weon Kim, Jinyong Hwang, Myung Ho H Jeong- Physiology (medical)
- Cardiology and Cardiovascular Medicine
Background: Limited data exist regarding the temporal progression of outcomes in patients with ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI). Research Questions: Are there any significant differences in the occurrence of cardiovascular events over time between patients with STEMI and NSTEMI in the modern era of percutaneous coronary intervention?
Aims: We aimed to compare the incidence rates of major cardiovascular events over time between patients with STEMI and NSTEMI using the Korea Acute Myocardial Infarction Registry-National Institutes of Health database.
Methods: We analysed the data of 13,056 patients diagnosed with STEMI or NSTEMI between 2011 and 2015 (median age, 65 years [interquartile range {IQR}, 54-74]). We calculated yearly, monthly, weekly, and daily time-point event rates after admission, considering the number of events during the specific periods divided by the number of event-free patients just before those periods. The primary outcome measure was all-cause mortality.
Results: During the 3-year follow-up (median, 1095 [IQR, 1044-1095] days), 12.4% of patients (1589/12,836) died from any cause. Patients with STEMI had a significantly higher mortality rate in the first week of admission than that of patients with NSTEMI (4.54% [283/6235] vs 1.76% [120/6823], P < 0.001), but this difference was not observed in the second week (0.59% [35/5952] vs 0.67% [45/6703], P = 0.635). Subsequently, higher mortality rates were observed in patients with NSTEMI than in those with STEMI for all time points. Daily outcome analysis revealed a gradual decrease in the difference in mortality rates in patients with STEMI versus NSTEMI from the first to the ninth day, followed by an inversion on the tenth day: STEMI: 2.39% (149/6235) vs NSTEMI: 0.59% (40/6823) on the first day; 0.13% (8/5942) vs 0.10% (7/6694) on the ninth day; and 0.03% (2/5934) vs 0.13% (9/6687) on the tenth day.
Conclusions: This analysis of temporal outcomes from a nationwide Korean registry demonstrated that patients with STEMI initially had higher mortality than patients with NSTEMI, but this difference gradually decreased and subsequently inverted during the second week, specifically after the ninth day.