Chonnam Med J.  2019 Jan;55(1):40-46. 10.4068/cmj.2019.55.1.40.

Predictors of In-Hospital Mortality in Korean Patients with Acute Myocardial Infarction

• Yang HY
• Ahn MJ
• Jeong MH
• Ahn Y
• Kim YJ
• Cho MC
• Kim CJ
• and other Korea Acute Myocardial Infarction Registry Investigators

• KMID: 2432254
• DOI: http://doi.org/10.4068/cmj.2019.55.1.40

Abstract

Acute myocardial infarction (AMI) is a fatal cardiovascular disease, and mortality is relatively high; therefore, integrated assessment is necessary for its management. There are several risk predictive models, but treatment trends have changed due to newly introduced medications and the universal use of percutaneous coronary intervention (PCI). The author aimed to find out predictive factors of in-hospital mortality in Korean patients with AMI. A group of 13,104 patients with AMI enrolled in the Korea Acute Myocardial Infarction Registry-National Institute of Health (KAMIR-NIH) registry were divided into two groups. One was a derivation group for evaluating mortality prediction; the other was a validation group for the application of risk prediction. In-hospital mortality was 4.2% (n=552). With hierarchical and stepwise multivariate analyses, nine factors were shown to predict in-hospital mortality for Korean patients with AMI. These were 1) being over 65 years of age, 2) high Killip class over II, 3) hyperglycemia over 180 mg/dl, 4) tachycardia over 100/min, 5) serum creatinine over 1.5 mg/dl, 6) atypical chest pain, 7) low systolic blood pressure under 90 mmHg, 8) low Thrombolysis In Myocardial Infarction (TIMI) flow (TIMI 0-II) before PCI and 9) low TIMI flow (TIMI 0-II) after PCI. The validation group showed a predictive power of 88.3%. Old age, high Killip class, hyperglycemia, tachycardia, renal dysfunction, atypical chest pain, low systolic blood pressure, and low TIMI flow are important risk factors of in-hospital mortality in Korean patients with AMI.

Keyword

Myocardial Infarction; Risk Factors; Prognosis

MeSH Terms

Blood Pressure
Cardiovascular Diseases
Chest Pain
Creatinine
Hospital Mortality*
Humans
Hyperglycemia
Korea
Mortality
Multivariate Analysis
Myocardial Infarction*
Percutaneous Coronary Intervention
Prognosis
Risk Factors
Tachycardia
Creatinine

Figure

• 

  FIG. 1 The receiver operating characteristic (ROC) curve using the predictive model. It shows area under curve of 0.87. AUC: area under the curve.

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