TỬ VONG VÀ CÁC BIẾN CỐ TIM MẠCH NỘI VIỆN Ở BỆNH NHÂN NHỒI MÁU CƠ TIM CẤP ST CHÊNH LÊN CÓ PHÂN SUẤT TỐNG MÁU THẤT TRÁI ≤40% SAU CAN THIỆP MẠCH VÀNH QUA DA

Abstract

Introduction: Despite significant advances in the diagnosis and treatment of acute myocardial infarction (AMI), the in-hospital mortality rate for AMI remains high. AMI patients with left ventricular ejection fraction (LVEF) < 40% on admission have increased mortality and complication rates such as reinfarction, arrhythmias, and stroke compared to those without heart failure or left ventricular dysfunction. In Vietnam, there have been few studies investigating in-hospital mortality in patients with anterior wall AMI and LVEF ≤40%. Objective: To determine the rate of all-cause in-hospital mortality in patients with STEMI and admission LVEF ≤ 40% after percutaneous coronary intervention (PCI) at Interventional Cardiology Department of Cho Ray Hospital. Subjects: Patients >18 years old diagnosed with STEMI and admission LVEF ≤ 40% undergoing PCI at Interventional Cardiology Department of Cho Ray Hospital from January 2023 to August 2023. Study design: Longitudinal observational cohort study. Results: 135 patients met the study criteria with a mean age ± standard deviation of 63 ± 10.67 years; the male/female ratio was 3.09/1. Diabetes (73.33%) and hypertension (67.41%) were the two most common risk factors. Anterior wall STEMI was the most common clinical presentation (58.66%) and 40.74% of patients were admitted with killip ≥ II. The most common in-hospital events were acute heart failure (37.04%) and acute kidney injury (21.48%); cardiogenic shock was observed in 14.07%. The in-hospital mortality rate in the target population was 8.89%, of which 91.67% were cardiovascular deaths. Multivariate logistic regression analysis found that only life-threatening arrhythmias were an independent predictor of in-hospital mortality. Conclusion: The in-hospital mortality rate in patients with STEMI and admission LVEF ≤ 40% after PCI was 8.89%. Life-threatening arrhythmias were an independent predictor of in-hospital mortality in this patient group.