What is the clinical evidence from this study?

Study design: Observational. Population: Acute myocardial infarction (n=13099). Intervention: STEMI vs. NSTEMI. Primary outcome: In-hospital mortality (p=<0.001).

What does this research mean for the field?

In-hospital mortality for acute myocardial infarction declined from 19.3% in 2014 to 7.7% in 2024 following the expansion of 24/7 primary percutaneous coronary intervention, with STEMI presenting a higher mortality risk than NSTEMI. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate 11-year temporal trends in acute myocardial infarction management and identify independent predictors of in-hospital mortality in a transitional healthcare system.

July 22, 2026BMC Cardiovascular DisordersOpen Access

Real-world management and outcomes of myocardial infarction in a transitional country: insights from an 11-year observational study of 13,099 patients

Q: What are the key findings of this study?

In-hospital mortality for acute myocardial infarction declined from 19.3% in 2014 to 7.7% in 2024, with STEMI presentation carrying a higher mortality risk than NSTEMI (12% vs 6%).

Q: What does this research mean for the field?

In-hospital mortality for acute myocardial infarction declined from 19.3% in 2014 to 7.7% in 2024 following the expansion of 24/7 primary percutaneous coronary intervention, with STEMI presenting a higher mortality risk than NSTEMI. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To evaluate 11-year temporal trends in acute myocardial infarction management and identify independent predictors of in-hospital mortality in a transitional healthcare system.

View Full Paper

Ask AI

Bookmark

Key result

In-hospital AMI mortality declined ~60% over a decade, though STEMI risk doubled NSTEMI.

P<0.001
n=13,099

Why the study?

In transitional health systems, in-hospital AMI mortality is higher due to limited reperfusion capacity and infrastructure limitations, warranting evaluation of management trends and mortality predictors following nationwide PPCI implementation in Kosovo.

Does the availability and use of primary percutaneous coronary intervention (PPCI) reduce in-hospital mortality in patients with acute myocardial infarction in a transitional healthcare system?

Key Points

To evaluate 11-year temporal trends in acute myocardial infarction management and identify independent predictors of in-hospital mortality in a transitional healthcare system.
Analyzed 13,099 consecutive patients hospitalized with acute myocardial infarction (7,156 STEMI and 5,943 NSTEMI) between 2014 and 2024 at Kosovo's main tertiary cardiology center.
Assessed practice patterns following the introduction of primary percutaneous coronary intervention (PPCI) in 2014 and nationwide 24/7 coverage achieved in 2018.
Identified independent predictors of in-hospital death using multivariable logistic regression modeling.
Overall in-hospital mortality was 9.0%, declining from 19.3% in 2014 to 7.7% in 2024, with the sharpest reduction occurring between 2014 and 2015 (19.3% to 10.8%).
Mortality was higher among STEMI than NSTEMI patients (12% vs. 6%, p < 0.001), while PPCI was performed in 63% of STEMI versus 48% of NSTEMI cases (p < 0.001).
Independent predictors of increased in-hospital mortality included cardiogenic shock, advanced age, female sex, reduced left ventricular ejection fraction, admission hyperglycaemia, and absence of PPCI.

Study Design

Type

Observational (n=13,099)

Multicenter

Structured PICO

Does the availability and use of primary percutaneous coronary intervention (PPCI) reduce in-hospital mortality in patients with acute myocardial infarction in a transitional healthcare system?

Population

13,099 adult patients hospitalized with acute myocardial infarction at a single tertiary center in Kosovo between 2014 and 2024, evaluated for in-hospital mortality.

Exposure

Primary percutaneous coronary intervention (PPCI) and standard AMI management

Comparator

Medical management or absence of PPCI

Outcome

In-hospital mortality (defined as death occurring between admission and discharge)hard clinical

Main Result

Absolute Event Rate: 12% vs 6%

p-value: p=<0.001

Limitations

Single-center, retrospective study
Potential missing data and referral bias
Unmeasured factors such as time to presentation and socioeconomic status may influence outcomes
Killip classification was not systematically recorded
Inability to calculate BMI due to lack of standard measures such as weight and height
single-center, retrospective study
potential missing data and referral bias
unmeasured factors (e.g., time to presentation, socioeconomic status)
Killip classification not systematically recorded
unable to calculate BMI due to lack of standard measures

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

Mortality trends in this Kosovo cohort may reflect care gains; leaves open PPCI's causal role without controlled data.

Cite This Study

Bajraktari et al. (2026) conducted an observational in Acute myocardial infarction (n=13,099). STEMI vs. NSTEMI was evaluated on In-hospital mortality (p=<0.001). In-hospital mortality for acute myocardial infarction declined from 19.3% in 2014 to 7.7% in 2024, with STEMI presentation carrying a higher mortality risk than NSTEMI (12% vs 6%).

synapsesocial.com/papers/6a6060374163e025518d8a2d https://doi.org/10.1186/s12872-026-06259-w

View Full Paper

Ask AI

Bookmark

Real-world management and outcomes of myocardial infarction in a transitional country: insights from an 11-year observational study of 13,099 patients

Key Points

Study Design

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

Real-world management and outcomes of myocardial infarction in a transitional country: insights from an 11-year observational study of 13,099 patients

Key Points

Study Design

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

Keep reading

Keep reading