Analysis of the research team at Korea University Anam Hospital and Yongin Severance Hospital Cardiovascular Medicine
ST-segment non-elevated myocardial infarction, 3-year mortality 1.62 times if hospitalized late
Suggested relationship with the increase in acute myocardial infarction mortality after the outbreak of COVID-19
In patients with ST-segment non-elevation myocardial infarction, a study result showed that delay in hospital admission after symptom onset increases the long-term mortality rate.
Acute myocardial infarction is divided into ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) according to the ST-segment elevation of the electrocardiogram. ST-segment elevation myocardial infarction is a case of blockage of large blood vessels in the heart, and the symptoms are usually severe.
The research team, led by Professor Tae-Hoon Ahn, Professor Jeong-Jun Cha, and Professor Seong-A Bae, Department of Cardiology, Yongin Severance Hospital, Korea University Anam Hospital, Department of Cardiology and Internal Medicine, conducted a three-year follow-up of 6,500 patients with ST-segment non-elevated acute myocardial infarction in the Korean Myocardial Infarction Registration Study (KAMIR-NIH). As a result of the analysis, it was announced on the 25th that, in patients with ST-segment non-elevation acute myocardial infarction, long-term mortality increased rapidly if they arrived at the hospital 24 hours after symptom onset. In particular, this study suggests the possibility that the tendency to avoid hospital treatment after the outbreak of COVID-19 is closely related to the increase in the mortality rate from acute myocardial infarction in the era of the COVID-19 infectious disease, which has not been able to explain the clear reason.
The research team analyzed the prognostic difference in patients with ST-segment non-elevated myocardial infarction by dividing the group into the group who arrived within 24 hours of symptom onset and the group who arrived after 24 hours. As a result, the three-year risk of death was 1.62 times higher in the group of patients who arrived after 24 hours compared to those who visited the hospital within 24 hours. The factors for delay in arrival at the hospital after 24 hours were the elderly, women, non-specific chest pain, dyspnea, diabetic patients, and non-use of 119 ambulances.
Professor Ahn Tae-hoon emphasized, “This research report is an important study that shows that it is very important for the long-term prognosis of myocardial infarction patients to visit a hospital quickly and get an accurate diagnosis and treatment when there is chest pain or shortness of breath in the Corona era.” Professor Cha Jeong-jun said, “Through this study, we were able to confirm that delay in hospital visits for patients with acute myocardial infarction is an important factor that increases the risk of death regardless of the patient’s underlying disease. In addition, cardiovascular disease treatment technology is world-class. Therefore, social efforts are needed so that acute myocardial infarction patients can visit the hospital within an appropriate time through continuous publicity and information sharing on the symptoms of acute myocardial infarction.” Professor Bae Seong-ah said, “ST-segment elevation myocardial infarction is often accompanied by severe symptoms and often comes to the hospital immediately. It is very important to visit the hospital early and receive treatment using the system.”
This study was published in the latest issue of the ‘Journal of the American College of Cardiology (IF=24.094)’ under the title ‘Clinical Outcomes in Patients With Delayed Hospitalization for Non-ST-Segment Elevation Myocardial Infarction’.
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