In-hospital mortality predictors in patients with non-ST-segment elevation myocardial infarction

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Ischemic heart disease is a leading cause of cardiovascular mortality. Non-ST-segment elevation myocardial infarction (NSTEMI) makes up for the majority of admissions to a cardiac unit. Purpose identify the predictors leading to in-hospital mortality in patients presenting with NSTEMI. Methods Based on a multicenter retrospective study, data collected from admissions between January 2013 and January 2020. Patients without data on previous cardiovascular history or uncompleted clinical data were excluded. Patients were divided in 2 groups (G): G1 – in-hospital death due to NSTEMI; G2 – patients with NSTEMI that survived. Logistic regression was performed. Results 7453 patients were admitted with NSTEMI, 90 patients (1.2%) died during the in-hospital stay. Regarding epidemiological and past history, G1 was older (74±11 vs 66±12, p<0.001), had higher rates of arterial hypertension (83.9% vs 72.7%, p=0.02), renal insufficiency (19.3% vs 6.1%, p<0.001) and dementia (5.3% vs 0.7%, p<0.001). G1 had more patients taking diuretics (54.9% vs 25.7%, p<0.001) previously to the hospital admission, presented more frequently with fatigue (6.0% vs 0.6%, p=0.01) and Killip-Kimball class (KKC) > 1 (51.8% vs 11.5%, p<0.001), had higher rates of elevated brain natriuretic peptide (BNP) (61.8% vs 23.8%, p<0.001), multivessel disease (74.2% vs 50.5%, p<0.001) and had worse left ventricular systolic function <30% (27.0% vs 2.4%, p<0.001). Logist regression confirmed that patients previously taking diuretics (p=0.01, OR 1.99, CI 1.16-3.42), presenting with fatigue (p=0.01, OR 5.75, CI 1.45-22.96) and KKC > 1 (p=0.001, OR 2.66, CI 1.51-4.66) and with severe left ventricular systolic dysfunction <30% (p=0.01, OR 2.57, CI 1.21-5.46) were predictors of in-hospital death in patients presenting with NSTEMI. Conclusion In-hospital mortality in the setting of NSTEMI was associated with patients taking diuretics previously to the admission, fatigue and Killip-Kimball class > 1 at admission and with poorer left ventricular systolic function.