KẾT CỤC TIM MẠCH NỘI VIỆN VÀ CÁC YẾU TỐ LIÊN QUAN Ở BỆNH NHÂN NHỒI MÁU CÕ TIM CẤP ST CHÊNH LÊN DO TẮC ÐOẠN GẦN ÐỘNG MẠCH VÀNH THỦ PHẠM

Abstract

Objectives: To investigate in-hospital cardiovascular outcomes and associated factors in patients with ST-segment elevation myocardial infarction (STEMI) caused by proximal culprit coronary artery occlusion. Methodology: A cohort study including 309 STEMI patients who underwent coronary angiography and were indicated for primary percutaneous coronary intervention (PCI) between January 2022 and December 2024. The in-hospital cardiovascular outcome rates were compared between patients with proximal and mid–distal culprit coronary artery lesions. Results: The mean age of the study population was 62.13 ± 11.21 years. There were 224 (72.5%) males and 85 (27.5%) female patients. Proximal lesions were identified in 159 patients (51.5%), while mid–distal lesions were found in 148 patients (47.9%). In the proximal occlusion group, in-hospital mortality and temporary pacemaker implantation rates were significantly higher (13.2%, p = 0.036 and 8.2%, p = 0.036). Cardiogenic shock, ventricular arrhythmias, high grade atrioventricular block, and mechanical complications tended to occur more frequently but without statistical significance. Multivariable logistic regression identified male gender, cardiogenic shock, and ventricular arrhythmias were independent predictors associated with an increased risk of in-hospital mortality. Conclusion: STEMI patients due to proximal culprit coronary occlusion exhibited a higher incidence of in-hospital adverse cardiovascular outcomes compared to those with mid-to-distal occlusion. Independent predictors of in-hospital mortality in STEMI patients included male gender, cardiogenic shock, and ventricular arrhythmias.