Batalli Arlind, Henein Michael, Poniku Afrim, Ibrahimi Pranvera, Pllana-Pruthi Edita, Elezi Shpend, Shatri Faik, Abdyli Genc, Bajraktari Artan, Karahoda Rona, Selmani Hamza, Bytyçi Ibadete, Bajraktari Gani
Clinic of Cardiology University Clinical Centre of Kosova Prishtina Kosovo.
Medical Faculty University of Prishtina Prishtina Kosovo.
Health Sci Rep. 2024 Oct 16;7(10):e70122. doi: 10.1002/hsr2.70122. eCollection 2024 Oct.
Myocardial infarction (MI) is cause of mortality worldwide, irrespective of its presentation as non-ST-segment elevation MI (NSTEMI) or ST-segment elevation MI (STEMI). The objective of this study was to assess national results of management and clinical outcome of acute MI patients in Kosovo.
This cross-sectional descriptive study, conducted at the Clinic of Cardiology of the University Clinical Center of Kosovo, in Prishtina, included all patients hospitalized with acute MI over a period of 7 years (2014-2020). The primary outcome of the study was in-hospital mortality.
Among 7353 admitted patients with acute MI (mean age 63 ± 12 years, 29% female) and according to the final diagnosis, 4436 (59.4%) patients had STEMI, and 2987 (40.6%) NSTEMI. More patients with STEMI received primary percutaneous intervention (PPCI) than those with NSTEMI (50% vs. 41%, < 0.001). In-hospital mortality was higher in no PPCI patients compared to PPCI both in NSTEMI (10.7% vs. 2.6%, < 0.001) and STEMI (20.9% vs. 6.8%, < 0.001). Age ≥65 years [0.399 (0.267-0.597), ˂ 0.001], hemoglobin level [0.889 (0.815-0.970), = 0.008], STEMI [0.491 (0.343-0.704), ˂ 0.001], lack of PPCI [2.636 (1.798-3.866), p ˂ 0.001], cardiogenic shock [0.002 (0.001-0.006), < 0.001], reduced left ventricular ejection fraction (LV EF) [0.966 (0.951-0.980), < 0.001], and heart rate at admission [1.009 (1.000-1.017), = 0.047], independently predicted mortality. In STEMI, cardiogenic shock ( ˂ 0.001), lack of PPCI ( = 0.006), female gender ( = 0.01), and low LV EF ( = 0.04) predicted mortality but age ≥65 years ( = 0.02), female gender ( = 0.02), low LV EF ( = 0.007), and low hemoglobin ( = 0.04) predicted mortality in NSTEMI.
Between 2014 and 2020, half of patients with acute MI were not treated with PPCI, who had high mortality, particularly when presenting with STEMI. Age, cardiogenic shock, anemia, low LV EF, STEMI and no PPCI independently predicted mortality. Cardiogenic shock and lack of PPCI independently predicted mortality, only in STEMI.
心肌梗死（MI）是全球范围内的死亡原因，无论其表现为非ST段抬高型心肌梗死（NSTEMI）还是ST段抬高型心肌梗死（STEMI）。本研究的目的是评估科索沃急性心肌梗死患者的全国管理结果和临床结局。
这项横断面描述性研究在普里什蒂纳的科索沃大学临床中心心脏病科进行，纳入了7年（2014 - 2020年）期间所有因急性心肌梗死住院的患者。该研究的主要结局是住院死亡率。
在7353例急性心肌梗死入院患者中（平均年龄63±12岁，29%为女性），根据最终诊断，4436例（59.4%）患者为STEMI，2987例（40.6%）为NSTEMI。接受直接经皮冠状动脉介入治疗（PPCI）的STEMI患者比NSTEMI患者更多（50%对41%，P<0.001）。在NSTEMI和STEMI患者中，未接受PPCI的患者的住院死亡率均高于接受PPCI的患者（NSTEMI中分别为10.7%对2.6%，P<0.001；STEMI中分别为20.9%对6.8%，P<0.001）。年龄≥65岁[0.399（0.267 - 0.597），P<0.001]、血红蛋白水平[0.889（0.815 - 0.970），P = 0.008]、STEMI[0.491（0.343 - 0.704），P<0.001]、未接受PPCI[2.六千三百六十（1.798 - 3.866），P<0.001]、心源性休克[0.002（0.001 - 0.006），P<0.001]、左心室射血分数（LV EF）降低[0.966（0.951 - 0.980），P<0.001]以及入院时心率[1.009（1.000 - 1.017），P = 0.047]独立预测死亡率。在STEMI中，心源性休克（P<0.001）、未接受PPCI（P = 0.006）、女性（P = 0.01）和低LV EF（P = 0.04）预测死亡率，但在NSTEMI中，年龄≥65岁（P = 0.02）、女性（P = 0.02）、低LV EF（P = 0.007）和低血红蛋白（P = 0.04）预测死亡率。
在2014年至2020年期间，一半的急性心肌梗死患者未接受PPCI治疗，这些患者死亡率高，尤其是STEMI患者。年龄、心源性休克、贫血、低LV EF、STEMI和未接受PPCI独立预测死亡率。心源性休克和未接受PPCI仅在STEMI中独立预测死亡率。
