Hemo-metabolic impairment in patients with ST-segment elevation myocardial infarction: Data from the INTERSTELLAR registry

초록

Background: Not only hemo-dynamic (HD) factors but also hemo-metabolic (HM) risk factors reflecting multi-organ injuries are considered as important prognostic factors in ST -segment elevation myocardial infarction (STEMI). However, studies regarding HM risk factors in STEMI patients are currently limited. Method: Under analysis were 1,524 patients with STEMI who underwent primary percutaneous coronary intervention in the INTERSTELLAR registry. Patients were divided into HM ( >= 2 risk fac - tors) and non -HM impairment groups. The primary outcome was in -hospital all-cause mortality, and the secondary outcome was 1-year all-cause mortality. Results: Of 1,524 patients, 214 (14.0%) and 1,310 (86.0%) patients were in the HM and non -HM impairment groups, respectively. Patients with HM impairment had a higher incidence of in -hospital mortality than those without (24.3% vs. 2.7%, p < 0.001). After adjusting for confounders, HM impair - ment was independently associated with in -hospital mortality (inverse probability of treatment weight - ing [IPTW]-adjusted odds ratio: 1.81, 95% confidence interval: 1.08-3.14). In the third door -to -balloon (DTB) time tertile ( <greater than or equal to> 82 min), HM impairment was strongly associated with in -hospital mortality. In the first DTB time tertile (< 62 min), indicating relatively rapid revascularization, HM impairment was consistently associated with increased in -hospital mortality. Conclusions: Hemo-metabolic impairment is significantly associated with increased risk of in -hospital and 1-year mortality in patients with STEMI. It remains a significant prognostic factor, regardless of DTB time. (Cardiol J 2024; 31, 3: 434-441)

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