Key result
Among patients with acute MI, STEMI was more common than NSTEMI (59.4% vs 40.6%) and was associated with a higher rate of primary percutaneous interventions (55.2% vs 43.6%, p<0.001).
Why the study?
Myocardial infarction is a major cause of mortality worldwide, and presentation as STEMI vs NSTEMI is influenced by atherosclerosis risk factors, prompting assessment of presentation patterns and risk factors in Kosovo.
Cross-Sectional (n=7,353)
No
Absolute Event Rate: 55.2% vs 43.6%
p-value: p=<0.001
In Kosovo, STEMI remains the more common presentation of acute MI compared to NSTEMI, with distinct risk factor profiles including higher rates of smoking in STEMI and higher rates of diabetes and hypertension in NSTEMI.
Distinct risk profiles by MI subtype in Kosovo may guide local prevention; leaves open generalizability and causal inference.
Background: Myocardial infarction (MI) is a major cause of mortality worldwide. Its presentation as ST-segment elevation MI (STEMI) and non-ST-segment elevation MI (NSTEMI) is influence by atherosclerosis risk factors. Aim: To assess the patterns of presentation and predicting risk factors of acute MI in Kosovo. Methods: This is a cross sectional study from the Clinic of Cardiology of the University Clinical Center of Kosovo, which included all patients hospitalized with acute MI over a period of 7 years (January 1st, 2014 to December 31st, 2020). Data was collected using a structured questionnaire and epidemiological patterns and risk factors were analyzed. Results: Among 7353 patients admitted with acute MI (age 63 ± 12 years, 29% female), 4366 (59.4%) patients had STEMI, and 2987 (40.6%) NSTEMI. Patients age was not different between the two groups (p=0.077). NSTEMI patients smoked less (48.3% vs. 54%, p<0.001), but were more diabetics (37.8% vs. 33.6%, p<0.001), more hypertensives (69.6% vs. 63%, p<0.001), frequently had family history for coronary artery disease (CAD) (40% vs 38%, p=0.009), and included more females compared to STEMI patients (32% vs 27%, p<0.001). The two groups of patients, did not differ in the prevalence of significant CAD on angiography (66.8% vs. 67.8%, p = 0.396), but NSTEMI patients underwent less primary percutaneous interventions compared with STEMI patients (43.6% vs. 55.2%, p < 0.001). Conclusion: In Kosovo, STEMI is commoner than NSTEMI, who were mostly males, more likely to have diabetes, hypertension and family history for CAD compared to those with NSTEMI. Smoking and arterial hypertension proved the strongest predictors of acute MI, in Kosovo, thus highlighting the urgent need for better atherosclerosis risk control and education strategy.
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Poniku et al. (2023) conducted a cross-sectional in Acute Myocardial Infarction (n=7,353). STEMI vs. NSTEMI was evaluated on Primary percutaneous intervention (p=<0.001). Among patients with acute MI, STEMI was more common than NSTEMI (59.4% vs 40.6%) and was associated with a higher rate of primary percutaneous interventions (55.2% vs 43.6%, p<0.001).
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