Predictive factors of short-term survival from acute myocardial infarction in early and late patients in Isfahan and Najafabad, Iran

Abstract

BACKGROUND: Cardiovascular disease (CVD) is the primary cause of mortality in the world and Iran. The aim of this study was to determine the prognostic factors of short-term survival from acute myocardial infarction (AMI) in early and late patients in the Najafabad and Isfahan County, Iran.

METHODS: This hospital-based cohort study was conducted using the hospital registry of 1999-2009 in Iran. All patients (n = 14426) with an AMI referred to hospitals of Isfahan and Najafabad were investigated. To determine prognostic factors of short-term (28-days) survival in early and late patients, unadjusted and adjusted hazard ratio (HR) was calculated using univariate and multivariate Cox regression.

RESULTS: The short-term (28-day) survival rate of early and late patients was 96.6 and 89.4% (P < 0.001), respectively. In 80.0% of early and 79.3% of late patients, mortality occurred during the first 7 days of disease occurrence. HR of death was higher in women in the two groups; it was 1.97 in early patients was [confidence interval (CI) 95%: 1.32-2.92] and 1.35 in late patients (CI 95%: 1.19-1.53) compared to men. HR of death had a rising trend with the increasing of age in the two groups.

CONCLUSION: Short-term survival rate was higher in early patients than in late patients. In addition, case fatality rate (CFR) of AMI in women was higher than in men. In both groups, sex, age, an atomic location of myocardial infarction based on the International Classification of Disease, Revision 10 (ICD10), cardiac enzymes, and clinical symptoms were significant predictors of survival in early and late patients following AMI.