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. 2024 Oct 16;7(10):e70122.
doi: 10.1002/hsr2.70122. eCollection 2024 Oct.

Management and clinical outcome of myocardial infarction in Kosovo: A cross-sectional study

Arlind Batalli  1   2 , Michael Henein  3 , Afrim Poniku  1   2 , Pranvera Ibrahimi  1   3 , Edita Pllana-Pruthi  1 , Shpend Elezi  1   2 , Faik Shatri  1 , Genc Abdyli  1   2 , Artan Bajraktari  1   3 , Rona Karahoda  4 , Hamza Selmani  1 , Ibadete Bytyçi  1   2   3 , Gani Bajraktari  1   2   3
Affiliations

Management and clinical outcome of myocardial infarction in Kosovo: A cross-sectional study

Arlind Batalli et al. Health Sci Rep. .

Abstract

Background and aims: Myocardial infarction (MI) is a major cause of mortality worldwide, irrespective of its presentation as non-ST-segment elevation MI (NSTEMI) or ST-segment elevation MI (STEMI). The objective of this study was to assess national results of management and clinical outcome of acute MI patients in Kosovo.

Methods: This cross-sectional descriptive study, conducted at the Clinic of Cardiology of the University Clinical Center of Kosovo, in Prishtina, included all patients hospitalized with acute MI over a period of 7 years (2014-2020). The primary outcome of the study was in-hospital mortality.

Results: Among 7353 admitted patients with acute MI (mean age 63 ± 12 years, 29% female) and according to the final diagnosis, 4436 (59.4%) patients had STEMI, and 2987 (40.6%) NSTEMI. More patients with STEMI received primary percutaneous intervention (PPCI) than those with NSTEMI (50% vs. 41%, p < 0.001). In-hospital mortality was higher in no PPCI patients compared to PPCI both in NSTEMI (10.7% vs. 2.6%, p < 0.001) and STEMI (20.9% vs. 6.8%, p < 0.001). Age ≥65 years [0.399 (0.267-0.597), p ˂ 0.001], hemoglobin level [0.889 (0.815-0.970), p = 0.008], STEMI [0.491 (0.343-0.704), p ˂ 0.001], lack of PPCI [2.636 (1.798-3.866), p ˂ 0.001], cardiogenic shock [0.002 (0.001-0.006), p < 0.001], reduced left ventricular ejection fraction (LV EF) [0.966 (0.951-0.980), p < 0.001], and heart rate at admission [1.009 (1.000-1.017), p = 0.047], independently predicted mortality. In STEMI, cardiogenic shock (p ˂ 0.001), lack of PPCI (p = 0.006), female gender (p = 0.01), and low LV EF (p = 0.04) predicted mortality but age ≥65 years (p = 0.02), female gender (p = 0.02), low LV EF (p = 0.007), and low hemoglobin (p = 0.04) predicted mortality in NSTEMI.

Conclusion: Between 2014 and 2020, half of patients with acute MI were not treated with PPCI, who had high mortality, particularly when presenting with STEMI. Age, cardiogenic shock, anemia, low LV EF, STEMI and no PPCI independently predicted mortality. Cardiogenic shock and lack of PPCI independently predicted mortality, only in STEMI.

Keywords: Kosovo; acute myocardial infarction; mortality; primary PCI.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
The coronary angiography and primary PCI rate in patients with STEMI and NSTEMI.
Figure 2
Figure 2
The coronary angiography and primary PCI rate in pateients with STEMI and NSTEMI.
Figure 3
Figure 3
Number of hospitalized patients with acute myocardial infarction and in‐hospital mortality rate during the seven years of the study.
Figure 4
Figure 4
Number of hospitalized patients with STEMI and in‐hospital mortality rate during the seven years of the study.
See this image and copyright information in PMC

References

    1. Vaduganathan M, Mensah G, Turco J, et al. The global burden of cardiovascular diseases and risk. J Am Coll Cardiol. 2022;80(25):2361‐2371. - PubMed
    1. Cram P, Hatfield LA, Bakx P, et al. Variation in revascularisation use and outcomes of patients in hospital with acute myocardial infarction across six high income countries: cross sectional cohort study. BMJ. 2022;377:e069164. - PMC - PubMed
    1. Kong G, Chin YH, Chong B, et al. Higher mortality in acute coronary syndrome patients without standard modifiable risk factors: results from a global meta‐analysis of 1,285,722 patients. Int J Cardiol. 2023;371:432‐440. - PubMed
    1. Ralapanawa U, Kumarasiri PVR, Jayawickreme KP, et al. Epidemiology and risk factors of patients with types of acute coronary syndrome presenting to a tertiary care hospital in Sri Lanka. BMC Cardiovasc Disord. 2019;19(1):229. 10.1186/s12872-019-1217-x - DOI - PMC - PubMed
    1. Wang JY, Goodman SG, Saltzman I, et al. Cardiovascular risk factors and in‐hospital mortality in acute coronary syndromes: insights from the Canadian Global Registry of Acute Coronary Events. Can J Cardiol. 2015;31(12):1455‐1461. - PubMed

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