Jose V Jacob, Gupta Satya N
Department of Cardiology, Christian Medical College, Vellore.
Indian Heart J. 2004 May-Jun;56(3):210-4.
The mortality rate of acute myocardial infarction has come down considerably in the past three decades. In view of paucity of literature on this issue, present study was done to find out the in-hospital mortality and 30-day event rate in patients with acute ST segment elevation myocardial infarction presenting to a tertiary care hospital in India.
Consecutive patients (n=1320) with the diagnosis of acute ST segment elevation myocardial infarction admitted in our institution were included in this study. The in-hospital mortality and 30-day event rates (mortality, reinfarction, recurrent angina and heart failure) were analyzed. The mean age of study population was 56+/-13 years. There were 1106 (83.8%) males and 214 (16.2%) females; 569 (43.1%) patients were smokers, 504 (38.2%) patients had hypertension, 531 (40.2%) patients were diabetic and 154 (11.7%) patients had past history of myocardial infarction. Anterior wall infarction was present in 752 (57%) patients, 517 (39.1%) patients had inferior wall infarction, 324 (62.7%) patients had associated right ventricular or posterior wall infarction and 51 (3.9%) patients had antero-inferior infarction; 1093 patients (82.8%) received thrombolytic therapy while 227 patients were not thrombolyzed due to various reasons. Of the total 1320 patients, 223 (16.9%) patients died during in-hospital stay while 1097 patients were discharged from the hospital in stable condition after a mean stay of 5.3+/-3.4 days. Thirty-day event rates of death, reinfarction and recurrent angina following hospital discharge was 18.8% (134/715 patients) and 36 (5%) patients presented with heart failure.
The in-hospital mortality rate of acute ST segment elevation myocardial infarction in a tertiary care hospital is 16.9%, which is higher compared to reports from the West.
在过去三十年中,急性心肌梗死的死亡率已大幅下降。鉴于关于此问题的文献较少,本研究旨在了解印度一家三级医疗医院中急性ST段抬高型心肌梗死患者的院内死亡率和30天事件发生率。
本研究纳入了在我院连续收治的诊断为急性ST段抬高型心肌梗死的患者(n = 1320)。分析了院内死亡率和30天事件发生率(死亡率、再梗死、复发性心绞痛和心力衰竭)。研究人群的平均年龄为56±13岁。男性1106例(83.8%),女性214例(16.2%);吸烟者569例(43.1%),高血压患者504例(38.2%),糖尿病患者531例(40.2%),有心肌梗死病史的患者154例(11.7%)。752例(57%)患者为前壁梗死,517例(39.1%)患者为下壁梗死,324例(62.7%)患者合并右心室或后壁梗死,51例(3.9%)患者为前下壁梗死;1093例患者(82.8%)接受了溶栓治疗,227例患者因各种原因未接受溶栓治疗。在总共1320例患者中,223例(16.9%)患者在住院期间死亡,1097例患者在平均住院5.3±3.4天后病情稳定出院。出院后30天的死亡、再梗死和复发性心绞痛事件发生率为18.8%(134/715例患者),36例(5%)患者出现心力衰竭。
三级医疗医院中急性ST段抬高型心肌梗死的院内死亡率为16.9%,与西方的报告相比更高。