Why the study?
Patients with STEMI may experience higher hospitalization costs and poorer prognosis compared to those with NSTEMI.
Do patients with STEMI have higher hospitalization costs and in-hospital mortality compared to patients with NSTEMI in a modern clinical context?
Do patients with STEMI have higher hospitalization costs and in-hospital mortality compared to patients with NSTEMI in a modern clinical context?
Answers are grounded in this paper and cite their sources.
In a contemporary Chinese PCI center, STEMI patients incurred significantly higher hospitalization costs, longer lengths of stay, and more frequent IABP usage than NSTEMI patients, though in-hospital mortality did not significantly differ between the two groups.
BACKGROUND: Patients with ST-segment elevation myocardial infarction (STEMI) may have higher hospitalization costs and poorer prognosis than non-ST-segment elevation myocardial infarction (NSTEMI). METHODS: A single-center retrospective study was conducted on 758 STEMI patients and 386 NSTEMI patients from January 1, 2020 to May 30, 2023 aimed to investigate the differences in cost and mortality. RESULTS: STEMI patients had higher maximal troponin I (15,222.5 (27.18, 40,000.00) vs. 2731.5 (10.73, 27,857.25), p < 0.001) and lower left ventricular ejection fraction (LVEF) (56% (53%, 59%) vs. 57% (55%, 59%), p < 0.001) compared to NSTEMI patients. The clinical symptoms were mainly persistent or interrupted chest pain/distress in either STEMI or NSTEMI patients. STEMI patients had a significantly higher risk of combined hypotension than NSTEMI patients (8.97% vs. 3.89%, p = 0.002), and IABP was much more frequently used in the STEMI group with a statistical difference (2.90% vs. 0.52%, p = 0.015). STEMI patients have statistically higher hospitalization costs (RMB, ¥) (31,667 (25,337.79, 39,790) vs. 30,506.91 (21,405.96, 40,233.75), p = 0.006) and longer hospitalization days (10 (8, 11) vs. 9 (8, 11), p = 0.001) compared to NSTEMI patients. Although in-hospital mortality was higher in STEMI patients, the difference was not statistically significant (3.56% vs. 2.07%, p = 0.167). Multivariable logistic regression was performed and found that systolic blood pressure and NT-proBNP were risk factors for patient death (OR ≥ 1). CONCLUSION: STEMI patients are more likely comorbid cardiogenic shock, heart failure complications with higher hospitalization costs and longer hospitalization days. And relatively more use of acute mechanical circulatory support devices such as IABP. TRIAL REGISTRATION: ChiCTR2300077885.
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Ma et al. (2024) studied this question.
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