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Epidemiologic pattern of myocardial infarction and modeling risk factors relevant to in-hospital mortality: the first results from Iranian Myocardial Infarction Registry.
MedLine Citation:
PMID:  25428813     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Myocardial infarction (MI) care and treatment contribute greatly to the patients' fatality and mortality. Assessing and monitoring mortalities and the effective factors are necessary in MI care and treatment programs. No comprehensive and population-based study has been yet conducted in Iran to determine the epidemiologic pattern of MI and particularly in-hospital mortality rate and the effective factors.
AIM: This study was aimed to determine the epidemiologic pattern of MI based on person, time, place and mortality-associated risk factors.
METHODS: This was a prospective, population-based cohort study which analyzed the data of 20750 MI patients in Iran in 2012. MI was diagnosed based on ICD10: the codes I21 and I22. The cohort of the patients was defined in terms of the date at diagnosis, hospitalization, and the date at discharge (recovery or death due to MI). The in-hospital mortality rate was calculated by Cox regression. Univariate analysis and multiple logistic regression were used to determine the effective factors on the patients' mortality. The odds ratio (95% confidence interval [CI]) was reported using Stata software.
RESULTS: The relative frequency of in-hospital mortality was 12.1%. The in-hospital mortality rate was higher in women than in men and 6.74 (95% CI, 6.4-7) of the patients were at risk. The highest relative frequency (13.2%) was obtained in January (11 Dey to 11 Bahman in Persian calendar) and the lowest (5.9%) in May (11 Ordibehest to 10 Khordad in Persian calendar). Age of over 84 years, female gender, educational level, smoking, lack of thrombolytic therapy, type 2 diabetes, chest pain prior to arriving in hospital, right bundle branch block, ventricular tachycardia, percutaneous coronary intervention, lateral MIs, and ST segment elevation myocardial infarction (STEMI) were determinants of in-hospital mortality in the patients. The relative frequency of mortality from STEMI and non STEMI was reported 83.7% and 16.3% respectively.
CONCLUSIONS: STEMI, Lack of thrombolytic therapy, the age of over 84 years, and ventricular tachycardia have the greatest effect on in-hospital mortality in MI patients. The results of this study are helpful in planning for monitoring and promotion of healthcare of the patients.
Authors:
Ali Ahmadi; Hamid Soori; Yadollah Mehrabi; Koorosh Etemad; Arsalan Khaledifar
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-11-27
Journal Detail:
Title:  Kardiologia polska     Volume:  -     ISSN:  0022-9032     ISO Abbreviation:  Kardiol Pol     Publication Date:  2014 Nov 
Date Detail:
Created Date:  2014-11-27     Completed Date:  -     Revised Date:  2014-11-28    
Medline Journal Info:
Nlm Unique ID:  0376352     Medline TA:  Kardiol Pol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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