Mortality from all causes in patients with myocardial infarction with elevation of st segment depending on the type of reperfusion therapy (data of ryazan region, 2018-2020)

Abstract

Aim. To assess mortality from all causes in patients with past myocardial infarction with elevation of ST segment (STEMI) depending on the type of reperfusion therapy.
 Materials and Methods. Of 1456 patients hospitalized with acute coronary syndrome with elevation of ST segment, 848 cases were randomly selected for analysis. Acquisition of information of the end point (death from any causes) continued within 18 months. The present data were obtained by 01.10.2020, median of observation was 20.8 [17.4;23.6] months.
 Results. The highest 18-month mortality (42.3%) was seen in the group of patients who did not receive reperfusion therapy. With this, mortality rate for 30 days in the group of thrombolytic therapy (TLT) and in the group without reperfusion did not show any significant differences (20.3% vs 26.2%, р0.05). Hospital, 30-day, 12-month, 18-month mortality from all causes in the group of percutaneous coronary intervention (PCI) made 8.4, 10.6, 16.6 and 18.3%, respectively, and was significantly lower compared to the group who did not receive reperfusion (19.5, 26.2, 36.2 and 42.3%, respectively, р0,05). The most significant differences in the frequency of the end point were recorded on achievement of 18-month limit: in the group without reperfusion mortality was 42.3%, that was higher (р0.05) compared to the given parameter in the group with TLT (27.1%), PCI (18.3%) and TLT+PCI (13.1%).
 Conclusion. During 18 months of observation, the lowest mortality from all causes was observed in the group with use of pharmacoinvasive approach and primary PCI, the highest mortality was in the group of patients who did not receive reperfusion therapy.