Differences in Clinical Outcomes Between Patients With ST-Elevation Versus Non-ST-Elevation Acute Myocardial Infarction in Korea
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Key result
NSTEMI patients had higher early survival than STEMI patients, but 12-month major adverse cardiac events were not significantly different between the two groups (20.4% vs 22.7%, p=0.121).
Why the study?
Do clinical outcomes differ between patients presenting with NSTEMI versus STEMI in the Korean population?
Population
13,133 patients aged ≥18 years admitted with acute myocardial infarction enrolled in the nationwide…
Comparison
Non-ST-segment elevation myocardial infarction… vs ST-segment elevation myocardial infarction…
Design
Cohort
Follow-up
12 months
Authors
Discussion
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Member takes
Implication
Distinct STEMI profiles in Korean AMI registry may inform risk stratification; leaves open outcome disparities for targeted research.
Key Points
- To compare clinical characteristics and 12-month outcomes between patients presenting with ST-elevation versus non-ST-elevation acute myocardial infarction.
- Prospective nationwide registry study analyzing 13,133 patients with acute myocardial infarction enrolled in the Korea Acute Myocardial Infarction Registry.
- Patients were categorized by the presence (STEMI) or absence (NSTEMI) of ST-segment elevation, with clinical and angiographic features assessed across 12 months of follow-up.
- Patients with STEMI were younger, more frequently male and smokers, and presented with poorer left ventricular function and higher initial cardiac death rates than those with NSTEMI.
- Patients with NSTEMI exhibited more comorbidities and a higher prevalence of complex multi-vessel and left main coronary artery disease.
- In-hospital and 1-month survival rates were higher in NSTEMI patients compared to STEMI patients, but 12-month survival rates were not significantly different between groups.
Study Design
Type
Cohort (n=13,133)
Multicenter
Yes
Structured PICO
Do clinical outcomes differ between patients presenting with NSTEMI versus STEMI in the Korean population?
P
Population
13,133 patients aged 18 years or older presenting with acute myocardial infarction enrolled in a nationwide prospective registry in South Korea, followed for 12 months.
E
Exposure
Non-ST-segment elevation myocardial infarction (NSTEMI) clinical presentation (n=5,278)
C
Comparator
ST-segment elevation myocardial infarction (STEMI) clinical presentation (n=7,855)
O
Outcome
Composite of major adverse cardiac events (MACE), including death from any cause, myocardial infarction, target vessel/lesion revascularization, and coronary artery bypass grafting (CABG) during a 12-month clinical follow-upcomposite
Main Result
Absolute Event Rate: 20.4% vs 22.7%
p-value: p=0.121
Limitations
- The proportion of patients followed up was relatively low with 63.0% at 6 months and 52.5% at 12 months.
- Proportion of patients followed up was relatively low with 63.0% at 6 months and 52.5% at 12 months
Cite This Study
Sim et al. (2009) conducted a cohort in Acute myocardial infarction (n=13,133). Non-ST-segment elevation myocardial infarction (NSTEMI) vs. ST-segment elevation myocardial infarction (STEMI) was evaluated on Composite of major adverse cardiac events (MACE), including death from any cause, myocardial infarction, target vessel/lesion revascularization, and coronary artery bypass grafting (CABG) at 12 months (p=0.121). NSTEMI patients had higher early survival than STEMI patients, but 12-month major adverse cardiac events were not significantly different between the two groups (20.4% vs 22.7%, p=0.121).
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