Abstract 9996: Clinical Features and Predictors of Non-Cardiac Death in Patients Hospitalized for Acute Myocardial Infarction

Abstract

Introduction: Patients with acute myocardial infarction (AMI) commonly have multiple co-morbidities, and some of these patients die in the hospital from causes other than cardiac complication. However, limited information is available on the mode of death in patients with AMI. Therefore, the present study was performed to determine the incidence, clinical characteristics and predictors of in-hospital non-cardiac death in patients with AMI, using Tokyo Cardiovascular Care Unit (CCU) network registry. Methods: Tokyo CCU network registry included 33,780 consecutive patients with AMI admitted to CCU between 2010-2018. The primary endpoint of the present study was in-hospital non-cardiac death. A stepwise regression model was used to identify the predictors of in-hospital non-cardiac death. Results: The incidence of all-cause in-hospital mortality was 7.1% (n = 2382), and the incidence was 16% (n = 381) and 84% (n = 2001) for non-cardiac and cardiac causes, respectively. The primary diseases responsible for non-cardiac deaths are shown in Figure. Old age was associated with in-hospital non-cardiac death, with a 29% increase in the risk per decade [odds 1.29, 95%CI (1.17-1.43), p < 0.001]. AMI onset in hospital [odds 2.78, 95%CI (1.98-3.92), p < 0.001], high grade of Killip class [odds 1.92, 95%CI (1.75-2.11), p < 0.001], no PCI [odds 1.76, 95%CI (1.32-2.34), p < 0.001] and history of maintenance haemodialysis [odds 2.13, 95%CI (1.38-3.30), p = 0.003] were associated with in-hospital non-cardiac death. Conclusions: The incidence of in-hospital non-cardiac death was significant in patients with AMI, accounting for 16% of all in-hospital deaths in the Tokyo CCU network registry. Thus, the prevention and management of non-cardiac complications are vital to reduce acute-phase mortality in patients with AMI, especially those with predictors of in-hospital non-cardiac death.