Survival after hospital discharge for ST-segment elevation and non-ST-segment elevation acute myocardial infarction: a population-based study

Figures & data

Table 2 Factors associated with post-discharge mortality according to type of AMI

Factor	STEMI			NSTEMI
	Hazard ratio	95% CI	P-value*	Hazard ratio	95% CI	P-value*
Age (per 10 year increase)	1.66	1.51–1.82	<0.001	1.76	1.66–1.87	<0.001
Male	1.14	0.92–1.42	0.35	1.24	1.10–1.38	<0.01
Length of stay (days)	1.03	1.01–1.05	<0.001	1.00	1.00–1.02	<0.01
Comorbidities
Hypertension	1.01	0.80–1.28	0.60	0.93	0.80–1.07	<0.01
Atrial fibrillation	1.25	0.91–1.71	0.23	1.13	0.98–1.30	0.57
Stroke	1.42	1.04–1.94	<0.05	1.45	1.26–1.67	<0.01
Congestive heart failure	1.82	1.38–2.39	<0.01	1.72	1.51–1.95	<0.001
Diabetes	1.21	0.95–1.54	<0.05	1.26	1.11–1.43	<0.05
Renal disease	1.22	0.92–1.61	0.67	1.27	1.11–1.46	0.33
Myocardial infarction	0.98	0.79–1.23	0.63	0.91	0.81–1.01	0.69
Hospital complications
Atrial fibrillation	1.34	1.05–1.71	<0.05	1.01	0.89–1.16	0.10
Stroke	1.27	0.64–2.54	0.49	1.38	0.94–2.03	<0.01
Cardiogenic shock	0.83	0.55–1.25	0.34	1.35	0.95–1.92	0.71
Heart failure	1.06	0.84–1.34	0.86	1.45	1.28–1.64	<0.001
Admission physiologic variables
Systolic blood pressure (per 10 mmHg increase)	0.99	0.96–1.02	<0.05	0.97	0.96–0.99	<0.05
Estimated glomerular filtration rate (mL/min/1.73 m^2)
<30	2.68	1.88–3.82	<0.001	2.04	1.69–2.46	<0.001
30–59	1.40	1.11–1.77	0.34	1.23	1.07–1.41	<0.01
Elevated blood glucose levels (per 10 mg/dL increase)	1.02	1.01–1.03	<0.01	1.00	1.00–1.01	<0.05

Note:

* P-value from accelerated failure time model.

Abbreviations: AMI, acute myocardial infarction; CI, confidence interval; NSTEMI, non-ST-segment elevation myocardial infarction; STEMI, ST-segment elevation myocardial infarction.

Table 1 Characteristics of patients with AMI according to type of AMI

	STEMI (n = 1223)	NSTEMI (n = 2539)	P-value
Demographics
Age (mean, years) (SD)	65.5 (14.3)	72.6 (13.6)	<0.001
Body mass index (mean)	28.1 (5.8)	27.9 (6.2)	0.40
Length of hospital stay (mean, days) (SD)	5.5 (5.1)	5.9 (6.2)	0.08
	n (%)	n (%)
Male	778 (63.6)	1370 (54.0)	<0.001
White race	1093 (89.4)	2259 (89.0)	0.71
Medical history
Atrial fibrillation	86 (7.0)	422 (16.6)	<0.001
Diabetes	305 (25.0)	952 (37.5)	<0.001
Heart failure	140 (11.5)	746 (29.4)	<0.001
Hypertension	765 (62.6)	1967 (77.5)	<0.001
Renal disease	145 (11.9)	541 (21.3)	<0.001
Stroke	85 (7.0)	338 (13.3)	<0.001
Initial MI	913 (74.7)	1539 (60.6)	<0.001
Hospital clinical complications	n (%)	n (%)
Atrial fibrillation	209 (17.1)	543 (21.4)	<0.01
Heart failure	350 (28.6)	1050 (41.4)	<0.001
Cardiogenic shock	81 (6.6)	48 (1.9)	<0.001
Stroke	11 (0.9)	32 (1.3)	0.33
Physiologic variables at hospital admission	mean (SD)
Systolic blood pressure (mmHg)	139.0 (31.3)	145.8 (32.9)	<0.001
Diastolic blood pressure (mmHg)	78.9 (20.6)	77.1 (20.5)	0.02
Glucose (mg/dL)	170.0 (85.5)	177.8 (108.7)	0.03
Total cholesterol (mg/dL)	176.4 (47.1)	172.8 (52.9)	0.10
Glomerular filtration rate (mL/min/1.73 m^2)	67.0 (26.5)	56.9 (24.2)	<0.001
Ejection fraction (%)	46.2 (12.9)	47.2 (14.1)	0.11
Medications at time of discharge	n (%)	n (%)
Aspirin	1085 (88.7)	2111 (83.1)	<0.001
Beta-blocker	1066 (87.2)	2108 (83.0)	<0.001
Anticoagulants	177 (14.5)	426 (16.8)	0.07
ACE-inhibitor or angiotensin receptor blocker	836 (68.4)	1469 (57.9)	<0.001
Calcium channel blocker	87 (7.1)	450 (17.7)	<0.001
Digoxin	112 (9.2)	407 (16.0)	<0.001
Lipid lowering agents	908 (74.2)	1696 (66.8)	<0.001
Procedures during hospitalization
Percutaneous coronary intervention	807 (66.0)	841 (33.1)	<0.001
Coronary bypass graft surgery	86 (7.0)	168 (6.6)	0.63

Abbreviations: ACE, angiotensin-converting-enzyme; AMI, acute myocardial infarction; MI, myocardial infarction; NSTEMI, non-ST-segment elevation myocardial infarction; SD, standard deviation; STEMI, ST-segment elevation myocardial infarction.

Figure 1 Post-discharge survival of patients according to type of AMI for patients enrolled in the Worcester Heart Attack Study in 2001, 2003, 2005, and 2007.

Note: Worcester Heart Attack Study data from.^11,12,14
Abbreviations: AMI, acute myocardial infarction; NSTEMI, non-ST-segment elevation myocardial infarction; STEMI, ST-segment elevation myocardial infarction.

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