In-Hospital Mortality Outcomes of ST-Segment Elevation Myocardial Infarction: A Cross-Sectional Study from a Tertiary Academic Hospital in Johannesburg, South Africa

Q: What does this research mean for the field?

The in-hospital all-cause mortality rate for STEMI patients in a South African tertiary hospital is 6.2%, and utilizing a pharmaco-invasive management strategy significantly reduces this mortality risk. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Lindokuhle Ndaba; Arthur Mutyaba; Dineo Mpanya; Nqoba Tsabedze

doi:10.3390/jcdd10080348

August 15, 2023Journal of Cardiovascular Development and DiseaseOpen Access

In-Hospital Mortality Outcomes of ST-Segment Elevation Myocardial Infarction: A Cross-Sectional Study from a Tertiary Academic Hospital in Johannesburg, South Africa

View Full Paper

Ask AI

Bookmark

Share

Why the study?

The burden of atherosclerotic cardiovascular disease is increasing in sub-Saharan Africa, but data describing the clinical characteristics and in-hospital all-cause mortality rate of STEMI patients were needed.

Does a pharmaco-invasive management strategy reduce in-hospital all-cause mortality in patients with STEMI?

Structured PICO

Does a pharmaco-invasive management strategy reduce in-hospital all-cause mortality in patients with STEMI?

P

Population

677 patients with ST-segment elevation myocardial infarction (STEMI) who underwent diagnostic coronary angiography with or without percutaneous coronary intervention (PCI), mean age 55.5 ± 11.3 years.

I

Intervention

Pharmaco-invasive management strategy (treatment with thrombolytic therapy and PCI)

C

Comparator

Other management strategies (not explicitly defined, likely primary PCI or medical therapy alone)

O

Outcome

In-hospital all-cause mortalityhard clinical

In a South African cohort of STEMI patients, the in-hospital mortality rate was 6.2%, and a pharmaco-invasive management strategy was associated with significantly reduced mortality.

Implication

May support pharmaco-invasive strategy in observational data; hypothesis-generating and should not change practice without RCTs.

Abstract

In sub-Saharan Africa, the burden of atherosclerotic cardiovascular disease (ASCVD) is increasing. This study aimed to describe the clinical characteristics of patients with ST-segment elevation myocardial infarction (STEMI) and estimate the in-hospital all-cause mortality rate. We conducted a cross-sectional retrospective single-centre study of STEMI patients who underwent diagnostic coronary angiography with or without percutaneous coronary intervention (PCI) between January 2015 and December 2019. We compared demographic and clinical parameters between survivors and non-survivors with descriptive statistics. Univariable and multivariable logistic regression analyses were performed to determine the predictors of all-cause mortality. The study population consisted of 677 patients with a mean age of 55.5 ± 11.3 years. The in-hospital all-cause mortality rate was 6.2% [95% confidence interval (CI): 4.5–8.3%]. Risk factors for ASCVD included smoking (56.1%), hypertension (52.8%), dyslipidemia (40.0%), and a family history of coronary artery disease (32.7%). A pharmaco-invasive management strategy (treatment with thrombolytic therapy and PCI) was implemented in 36.5% of patients and reduced all-cause mortality risk (OR: 0.16; CI: 0.04–0.71, p = 0.015). The in-hospital all-cause mortality rate in STEMI patients was 6.2%, and a pharmaco-invasive management strategy proved to be an effective approach.