Impact of patient-related and treatment-related factors on in-hospital mortality of patients with ST-elevation myocardial infarction: Data of Russian Acute Coronary Syndrome Registry

Objective — We examined relationships between inpatient medical treatment, reperfusion therapy and in-hospital mortality among patients with ST-elevation myocardial infarction (STEMI) in Russia. Methods — Clinical information about 25,682 patients with STEMI enrolled in the 2010–2011 registry was included retrospectively in the study. Performance of the key guideline-recommended treatment interventions was assessed. Timeliness of reperfusion therapy was evaluated with the help of the following ACC/AHA clinical measures (2008): Time to fibrinolytic therapy, Time to primary percutaneous coronary intervention (PCI) and Reperfusion therapy. Multivariate logistic and Cox's regression models were used to assess the relationship between different in-hospital treatment interventions and the risk of in-hospital death among patients with STEMI under the control of patient characteristics and comorbidities. Results — The average age of patients was 63 (55–74) years. 34% of patients were female. Survived patients differed significantly from deceased ones in the majority of demographic, anamnesis, clinical presentation and treatment parameters. Hospital treatment with ACE-Is or ARBs, β-blockers and statins was significantly associated (χ2=482.1, P