Analysis of risk factors of in-hospital death in acute myocardial infarction patients with normal left ventricular ejection fraction

Abstract

Objective To investigate the risk factors of in-hospital death in patients with acute myocardial infarction (AMI) with normal left ventricular ejection fraction (LVEF). Methods From January 2014 to June 2017, patients admitted with AMI diagnosis, LVEF> 50%, and Killip classification Ⅰ or Ⅱ were included. Participants were divided into two groups, namely, in-hospital death group and control group. Student t-test and chi-square test were used to compare the clinical data of the two groups, logistic regression was used to analyze the risk factors of in-hospital death. Results A total of 736 patients were enrolled, including 45 patients (6.1%) in the in-hospital death group and 691 patients (93.9%) in the control group. There were statistically significant differences in age, gender, history of cerebrovascular disease, history of AMI, disease-to-admission time, method of admission, myocardial infarction site, revascularization, QRS duration, BNP, peak-cTnT, peak-CK-MB, ALT and eGFR (all P<0.05). Multivariate logistic regression results showed that advanced age [odds ratio (OR) =2.521], history of AMI (OR=2.741), prolonged disease-to-admission time (OR=1.687), referral to lower-level hospitals (OR=2.372), anterior wall or extensive anterior myocardial infarction (OR=3.231), and reduced eGFR (OR=2.077) were risk factors for in-hospital death in AMI patients with normal LVEF, while male gender (OR=0.512) and revascularization therapy (OR=0.237) were protective factors. Conclusions Advanced age, previous history of AMI, prolonged onset-to-admission time, referral to lower-level hospitals, anterior wall or extensive anterior myocardial infarction, and reduced renal function are risk factors for in-hospital death in AMI patients with normal LVEF, while male and revascularization therapy are protective factors. Key words: Left ventricular ejection fraction; Acute myocardial infarction; In-hospital death; Risk factors