Abstract 10432: Variables Associated With Mortality in Patients With ST Elevation Myocardial Infarction and Heart Failure at Admission. Registry ARGEN-IAM-ST

Abstract

Introduction: Hemodynamic complications associated with ST elevation myocardial infarction (STEMI) continue to be an unfavorable prognostic marker in patients (pts) who develop it. Objectives: Know the demographic, clinical, laboratory, electrocardiographic, and reperfusion variables associated with the change in mortality of STEMI patients with heart failure (HF) at admission. Material and Method: Data from the National Registry of STEMI of Argentina (ARGEN-IAM-ST) from 1/1/2016 to 9/30/2020 were analyzed. Pts with Killip and Kimball equal to or greater than 2 at admission were included. They were divided into alive vs dead according to this condition during hospitalization. Demographic, clinical, electrocardiographic, laboratory variables, and reperfusion characteristics at admission were compared. Univariate and multivariate analyzes were performed. Results: 708 pts were included. Mortality was 28.39% (N=201) (Figure 1). When comparing the alive vs dead groups, the mean age was 62.96 (SD±12.02) vs 66.70 (SD±12.05) years, p=0.0002; women 21.10% (N=107) vs 32.30% (N=65), p=0.002 respectively. The baseline characteristics are observed in Table 1. Reperfusion was performed in 88.56% of alive vs. 85.07% of dead [OR 0.74 (95%CI 0.46-1.18), p=0.2]. Successful reperfusion by primary percutaneous coronary intervention (PPCI) was more frequent in the alive, 96.59% vs 76.15% [OR 0.11 (95%CI 0.05-0.23), p<0.001], table 2. In multivariate analysis, successful reperfusion with thrombolytics was associated with a decrease in mortality, OR 0.19 (95 %CI 0.04-0.81), p=0.025; as well as successful reperfusion with PPCI, OR 0.11 (95%CI 0.05-0.28), p<0.001. The rest of the variables that modified survival are shown in Table 3. Conclusions: Patients with STEMI who are admitted with HF and die during hospitalization have different baseline characteristics than those who survive. Successful reperfusion therapy is associated with decreased mortality.