Clinical and laboratory predictors of early mortality in patients with acute myocardial infarction treated with primary percutaneous coronary intervention

Introduction: Primary percutaneous coronary intervention (pPCI) has become the preferred reperfusion strategy in patients with ST-elevation myocardial infarction (STEMI). Previous research studies have shown that certain clinical and laboratory parameters can be associated with early mortality in patients with acute myocardial infarction treated by primary PCI. The Aim: The aim of our study was to determine the clinical and laboratory predictors of an adverse early prognosis of our patients with STEMI treated by primary PCI. Material and Methods: The population of our IV phase, academic, observational, retrospective cross-sectional study comprises a total of 180 consecutive patients, 128 men and 52 women, aged 18, or older, who presented with clinical and electrocardiographic signs of acute STEMI within 12 hours after symptom onset. We analyzed the parameters which were registered in the database system of the Coronary Unit of Emergency Center. Results: The average age of the surviving patients was 58±11, and 67±9 in the deceased patient group but the correlation was not statistically significant (p=0.075). The group of patients who didn't survive had significantly more hypotension on admission (p=0.015), acute bundle branch block on ECG (p=0.032), higher creatinine on admission (p=0.036), patient history of hyperlipidaemia (p=0.044), creatinine clearance below 60ccs/min (p1 heart failure on admission (p=0.038), but this group contained a significantly lower number of smokers (p=0.021). Predictors of an adverse early event in multivariant analysis were: acute bundle branch block, diabetes, Killip> 1 on admission, hypotension on admission, creatinine clearance below 60ccs/min. Conclusions: Our study indicates that acute bundle branch block, diabetes, Killip>1 heart failure on admission, hypotension on admission, creatinine clearence below 60ccs/min, are independent clinical and laboratory predictors of early mortality in patients with STEMI treated by primary PCI.