Difference in the in-hospital prognosis between ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction with high Killip class: Data from the Japan Acute Myocardial Infarction Registry

被引：9

作者：

Fukutomi, Motoki ^{[1
]}

Nishihira, Kensaku ^{[2
]}

Honda, Satoshi ^{[2
]}

Kojima, Sunao ^{[3
]}

Takegami, Misa ^{[4
]}

Takahashi, Jun ^{[5
]}

Itoh, Tomonori ^{[6
]}

Watanabe, Tetsu ^{[7
]}

Takenaka, Takashi ^{[8
]}

Ito, Masaaki ^{[9
]}

Takayama, Morimasa ^{[10
]}

Kario, Kazuomi ^{[1
]}

Sumiyoshi, Tetsuya ^{[10
]}

Kimura, Kazuo ^{[11
]}

Yasuda, Satoshi ^{[2
]}

机构：

[1] Jichi Med Univ, Div Cardiovasc Med, Sch Med, Shimotsuke, Tochigi, Japan

[2] Natl Cerebral & Cardiovasc Ctr, Dept Cardiovasc Med, Suita, Osaka, Japan

[3] Kawasaki Med Sch, Dept Gen Internal Med 3, Kurashiki, Okayama, Japan

[4] Natl Cerebral & Cardiovasc Ctr, Dept Prevent Med & Epidemiol Informat, Suita, Osaka, Japan

[5] Tohoku Univ, Grad Sch Med, Dept Cardiovasc Med, Sendai, Miyagi, Japan

[6] Iwate Med Univ, Div Cardiol, Morioka, Iwate, Japan

[7] Yamagata Univ, Sch Med, Dept Cardiol Pulmonol & Nephrol, Yamagata, Japan

[8] Hokkaido Med Ctr, Dept Cardiol, Sapporo, Hokkaido, Japan

[9] Mie Univ, Dept Cardiol & Nephrol, Grad Sch Med, Tsu, Mie, Japan

[10] Sakakibara Heart Inst, Dept Cardiol, Fuchu, Tokyo, Japan

[11] Yokohama City Univ Med Ctr, Div Cardiol, Yokohama, Kanagawa, Japan

来源：

EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE | 2021年 / 10卷 / 05期

关键词：

Elderly; high Killip class; non-ST-segment elevation myocardial infarction; outcome; ST-segment elevation myocardial infarction; PERCUTANEOUS CORONARY INTERVENTION; HEART-FAILURE; NATIONAL-REGISTRY; ELDERLY-PATIENTS; GLOBAL REGISTRY; MANAGEMENT; OUTCOMES; IMPACT; PREDICTORS; MORTALITY;

D O I：

10.1177/2048872620926681

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background ST-segment elevation myocardial infarction is known to be associated with worse short-term outcome than non-ST-segment elevation myocardial infarction. However, whether or not this trend holds true in patients with a high Killip class has been unclear. Methods We analyzed 3704 acute myocardial infarction patients with Killip II-IV class from the Japan Acute Myocardial Infarction Registry and compared the short-term outcomes between ST-segment elevation myocardial infarction (n = 2943) and non-ST-segment elevation myocardial infarction (n = 761). In addition, we also performed the same analysis in different age subgroups: Results In the overall population, there were no significant difference in the in-hospital mortality (20.0% vs 17.1%, p = 0.065) between ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction groups. Patients <80 years of age also showed no difference in the in-hospital mortality (15.7% vs 15.2%, p = 0.807) between ST-segment elevation myocardial infarction (n = 2001) and non-ST-segment elevation myocardial infarction (n = 453) groups, whereas among those >= 80 years of age, ST-segment elevation myocardial infarction (n = 942) was associated with significantly higher in-hospital mortality (29.3% vs 19.8%, p = 0.001) and in-hospital cardiac mortality (23.3% vs 15.0%, p = 0.002) than non-ST-segment elevation myocardial infarction (n = 308). After adjusting for covariates, ST-segment elevation myocardial infarction was a significant predictor for in-hospital mortality (odds ratio 2.117; 95% confidence interval, 1.204-3.722; p = 0.009) in patients >= 80 years of age. Conclusion Among cases of acute myocardial infarction with a high Killip class, there was no marked difference in the short-term outcomes between ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction in younger patients, while ST-segment elevation myocardial infarction showed worse short-term outcomes in elderly patients than non-ST-segment elevation myocardial infarction. Future study identifying the prognostic factors for the specific anticipation intensive cares is needed in this high-risk group.

引用

页码：503 / 512

页数：10

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