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. 2023 Aug 15;10(8):348.
doi: 10.3390/jcdd10080348.

In-Hospital Mortality Outcomes of ST-Segment Elevation Myocardial Infarction: A Cross-Sectional Study from a Tertiary Academic Hospital in Johannesburg, South Africa

Lindokuhle Ndaba  1 , Arthur Mutyaba  1 , Dineo Mpanya  1 , Nqoba Tsabedze  1
Affiliations

In-Hospital Mortality Outcomes of ST-Segment Elevation Myocardial Infarction: A Cross-Sectional Study from a Tertiary Academic Hospital in Johannesburg, South Africa

Lindokuhle Ndaba et al. J Cardiovasc Dev Dis. .

Abstract

In sub-Saharan Africa, the burden of atherosclerotic cardiovascular disease (ASCVD) is increasing. This study aimed to describe the clinical characteristics of patients with ST-segment elevation myocardial infarction (STEMI) and estimate the in-hospital all-cause mortality rate. We conducted a cross-sectional retrospective single-centre study of STEMI patients who underwent diagnostic coronary angiography with or without percutaneous coronary intervention (PCI) between January 2015 and December 2019. We compared demographic and clinical parameters between survivors and non-survivors with descriptive statistics. Univariable and multivariable logistic regression analyses were performed to determine the predictors of all-cause mortality. The study population consisted of 677 patients with a mean age of 55.5 ± 11.3 years. The in-hospital all-cause mortality rate was 6.2% [95% confidence interval (CI): 4.5-8.3%]. Risk factors for ASCVD included smoking (56.1%), hypertension (52.8%), dyslipidemia (40.0%), and a family history of coronary artery disease (32.7%). A pharmaco-invasive management strategy (treatment with thrombolytic therapy and PCI) was implemented in 36.5% of patients and reduced all-cause mortality risk (OR: 0.16; CI: 0.04-0.71, p = 0.015). The in-hospital all-cause mortality rate in STEMI patients was 6.2%, and a pharmaco-invasive management strategy proved to be an effective approach.

Keywords: ST-segment elevation myocardial infarction; Sub-Saharan Africa; acute coronary syndrome; cardiovascular epidemiology; mortality; percutaneous coronary intervention.

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Conflict of interest statement

N.T. is a consultant cardiologist. He has received consultation fees from Novartis Pharmaceuticals, Novo Nordisk, Boston Scientific, Pfizer, Servier, Phillips, Takeda, AstraZeneca, Acino Health Care Group, and Merck. He has also received educational and travel grants from Medtronic, Biotronik, Boston Scientific, and Vertice Health Care Group.

Figures

Figure 1
Figure 1
Flow chart outlining enrolment of patients into the study. STEMI: ST-segment elevation myocardial infarction.
Figure 2
Figure 2
Co-morbidities for ST-segment elevation myocardial infarction. CAD: coronary artery disease.
Figure 3
Figure 3
Management strategies in patients with ST-segment elevation myocardial infarction. PCI: percutaneous coronary intervention.
See this image and copyright information in PMC

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