Prevalence and associated factors of mortality after percutaneous coronary intervention for adult patients with ST-elevation myocardial infarction: A systematic review and meta-analysis
Fanghong Yan1, Yuanyuan Zhang2, Yayan Pan3, Sijun Li4, Mengqi Yang3, Yutan Wang5, Chen Yanru3, Wenli Su3, Yuxia Ma3, Lin Han6
1 Evidence-Based Nursing Center, School of Nursing; The First School of Clinical Medicine, Lanzhou University, Lanzhou, China 2 Department of Respiratory Medicine, Henan Cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China 3 Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China 4 Department of New Technology Development, SceneRay, Suzhou, 215000, China 5 Department of Hepatopancreatobiliary Surgery, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China 6 Evidence-Based Nursing Center, School of Nursing; The First School of Clinical Medicine, Lanzhou University, Lanzhou, China; Department of Nursing, Gansu Provincial Hospital, Lanzhou, Gansu Province, China
Date of Submission | 06-Sep-2021 |
Date of Decision | 13-Oct-2022 |
Date of Acceptance | 17-Nov-2022 |
Date of Web Publication | 16-Mar-2023 |
Correspondence Address: Prof. Lin Han Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou; The First Hospital of Lanzhou University, Lanzhou; Department of Nursing, Gansu Provincial Hospital, Lanzhou China
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jrms.jrms_781_21
Background: There is a paucity of systematic reviews on the associated factors of mortality among ST-elevation myocardial infarction (STEMI) patients after percutaneous coronary intervention (PCI). This meta-analysis was designed to synthesize available evidence on the prevalence and associated factors of mortality after PCI for adult patients with STEMI. Materials and Methods: Databases including the Cochrane Library, PubMed, Web of Science, Embase, Ovid, Scopus, ProQuest, MEDLINE, and CINAHL Complete were searched systematically to identify relevant articles published from January 2008 to March 2020 on factors affecting mortality after PCI in STEMI patients. Meta-analysis was conducted using Stata 12.0 software package. Results: Our search yielded 91 cohort studies involving a total of 199, 339 participants. The pooled mortality rate for STEMI patients after PCI was 10%. After controlling for grouping criteria or follow-up time, the following 17 risk factors were significantly associated with mortality for STEMI patients after PCI: advanced age (odds ratio [OR] = 3.89), female (OR = 2.01), out-of-hospital cardiac arrest (OR = 5.55), cardiogenic shock (OR = 4.83), renal dysfunction (OR = 3.50), admission anemia (OR = 3.28), hyperuricemia (OR = 2.71), elevated blood glucose level (OR = 2.00), diabetes mellitus (OR = 1.8), chronic total occlusion (OR = 2.56), Q wave (OR = 2.18), without prodromal angina (OR = 2.12), delay in door-to-balloon time (OR = 1.72), delay in symptom onset-to-balloon time (OR = 1.43), anterior infarction (OR = 1.66), ST-segment resolution (OR = 1.40), and delay in symptom onset-to-door time (OR = 1.29). Conclusion: The pooled prevalence of mortality after PCI for STEMI patients was 10%, and 17 risk factors were significantly associated with mortality for STEMI patients after PCI.
Keywords: Meta-analysis, mortality, percutaneous coronary intervention, ST-elevation myocardial infarction
How to cite this article: Yan F, Zhang Y, Pan Y, Li S, Yang M, Wang Y, Yanru C, Su W, Ma Y, Han L. Prevalence and associated factors of mortality after percutaneous coronary intervention for adult patients with ST-elevation myocardial infarction: A systematic review and meta-analysis. J Res Med Sci 2023;28:17 |
How to cite this URL: Yan F, Zhang Y, Pan Y, Li S, Yang M, Wang Y, Yanru C, Su W, Ma Y, Han L. Prevalence and associated factors of mortality after percutaneous coronary intervention for adult patients with ST-elevation myocardial infarction: A systematic review and meta-analysis. J Res Med Sci [serial online] 2023 [cited 2023 Jun 2];28:17. Available from: https://www.jmsjournal.net/text.asp?2023/28/1/17/371845 |
#These authors contributed equally to this work.
Introduction | |  |
ST-elevation myocardial infarction (STEMI) is the most common type of myocardial infarction, accounting for 74.15% of all myocardial infarcts,[1] and it is the leading cause of death in cardiovascular patients.[2] Percutaneous coronary intervention (PCI) is recommended as the preferred treatment for patients with STEMI due to reduce reinfarction, mortality compared with fibrinolysis.[3] However, STEMI patients still have to face a series of physiological and psychological problems after PCI, especially all-cause death events. Moreover, it is not clear whether this development will improve survival in patients with STEMI. Most national studies reported a consequent reduction in mortality in unselected STEMI patients compared with thrombolysis, which was insufficient to assess the extent of the improvement.[4],[5],[6] There was a considerable difference in mortality (1.5% to 48.1%) in studies with 1-year follow-up after PCI.[7],[8] Therefore, it is necessary to systematically synthesize the mortality rate for patients with STEMI following PCI.
Furthermore, the occurrence and development of mortality were the results of the additive effect of multiple factors. Studies have shown that there were many risk factors for mortality, including age,[9] gender,[10] blood glucose levels,[11] and door-to-balloon time (DTB)[12]. However, no systematic review has synthesized the evidence of screening-associated factors. Therefore, this study will systematically evaluate the mortality and risk factors of STEMI patients after PCI, to provide a theoretical basis for designing a cost-effective prevention program to control factors, and further improve the prognosis and reduce the mortality of adult STEMI patients after PCI.[13],[14]
Methods | |  |
The manuscript has been prepared according to the meta-analysis of observational studies in epidemiology guidelines.[15] Ethical approval was unnecessary in this study, because it was a meta-analysis of existing articles, and no individual patient data were handled. This review has been registered on PROSPERO (CRD 42017070969) and the protocol[16] has been published, the authors declare that all method details are available within the article, and any additional information is available from the corresponding author on reasonable request.
In this study, we stratified participants based on factors that reported an association with mortality for STEMI patients after PCI, and then assessed mortality prevalence. Studies associated with a specific factor for which there are ≤2 studies will be excluded. Due to the inconsistency between the retrieved factors and the categories defined in the protocol,[16] we did not categorize the included factors for presentation. Some risk factors, grouping criteria, and follow-up periods varied by study and were not standardized. Therefore, subgroup analyses were performed according to factors' grouping criteria and follow-up period when significant and practicable. If a study held two or more grouping criteria and follow-up period, which were included in each subgroup analysis. Moreover, due to the small weight in the pooled effect of Chinese literature, we did not retrieve the Chinese database according to the content in the protocol.
Results | |  |
According to the search strategy, the initial search retrieved 28,015 articles, of which 9554 were duplicates. After screening titles and abstracts, 333 articles were selected on the basis of inclusion criteria. The full-text of the remaining 333 studies were further evaluated in detail, of which 91 were considered eligible for this review, and more details are in [Figure 1].
Ninety-one studies examined 23 risk factors for mortality after PCI for adult STEMI patients. Of them, 65 articles were prospective cohort studies, while 26 articles were retrospective cohort studies. The number of patients in the included studies ranged from 131[17] to 17,021,[18] other characteristics of included studies are summarized in [Table 1]. Quality assessment results are listed in [Table 2], of which 42 studies were evaluated to be at low risk of bias.
Prevalence of mortality
The prevalence of mortality ranged from 2% to 59% among 91 studies available for this analysis. The pooled mortality rate for STEMI patients after PCI was 10% (95% confidence interval [CI]: 9%–11%) with high heterogeneity (I2 = 98.8%, P < 0.001) [Figure 2]. Funnel plot indicated no publication bias, and more details are in [Figure 3]. | Figure 2: The pooled mortality rate for STEMI patients after PCI. STEMI = ST-elevation myocardial infarction; PCI = Percutaneous coronary intervention
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Mortality prevalence based on associated factors
Advanced age
Advanced age was a risk factor (odds ratio [OR] = 3.89, 95% CI: 3.47–4.37, I2 = 78.60%, P < 0.001, Population Attributable Fraction (PAF) = 32.9%) we retrieved from 15 articles (N = 28, 360) in this study [Table 3]. The pooled mortality rate for STEMI patients after PCI at an advanced age was 17% (95% CI: 14%–21%) with high heterogeneity (I2 = 97.50%, P < 0.001). In a subgroup of two studies (N = 4, 148) with advanced age definition at or above 45 and 30-day follow-up (OR = 2.42, 95% CI: 1.28–4.59, I2 = 0.00%, P = 0.007, PAF = 6.6%), the pooled mortality rate was 5% (95%CI: 4%-5%) with low heterogeneity (I2 = 11.80%, P = 0.287). For the subgroup of nine studies (N = 15, 339) with advanced age definition at or above 75 (OR = 4.90, 95% CI: 3.95–6.09, I2 = 50.40%, P < 0.001, PAF = 41.2%), the pooled mortality rate was 18% (95% CI: 14%–22%) with high heterogeneity (I2 = 89.70%, P < 0.001). The high heterogeneity could be explained by the variation of the follow-up period, the pooled mortality rate for six studies (N = 13, 168) with 30-day follow-up was 11% (95% CI: 9%–12%) with low heterogeneity (I2 = 0.00%, P = 0.49), while the pooled mortality rate for four studies (N = 7, 006) with 1-year follow-up was 17% (95% CI: 15%–20%) with low heterogeneity (I2 = 55.70%, P = 0.079). For the remaining three studies (N = 7, 831) with advanced age definition at or above 80 (OR = 4.36, 95%CI: 3.66–5.19, I2 = 32.90%, P < 0.001, PAF = 51.8%), the pooled mortality rate was 32% (95% CI: 23%–40%) with high heterogeneity (I2 = 84.50%, P = 0.002). The significant heterogeneity could also be explained by the variation of the follow-up period, the pooled mortality rate for two studies (N = 5, 829) with 30-day follow-up was 18% (95% CI, 12%–25%) with medium heterogeneity (I2 = 72.60%, P = 0.056), while the pooled mortality rate for two studies (N = 5, 829) with 1-year follow-up was 27% (95% CI, 24%–31%) with low heterogeneity (I2 = 0.00%, P = 0.5). | Table 3: Meta-analysis of the correlation between risk factors and mortality
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Female
Across 15 studies (N = 47, 782) in [Table 3] reported female was a risk factor (OR = 2.01, 95% CI: 1.87–2.16, I2 = 46.30%, P < 0.001, PAF = 10.0%) of mortality for STEMI patients after PCI. The pooled mortality rate for female patients was 11% (95% CI: 8%–13%) with high heterogeneity (I2 = 91.30%, P < 0.001). In a subgroup of 11 studies (N = 43, 236) with 30-day follow-up, the pooled mortality rate was 8% (95% CI: 6%–10%) with significant heterogeneity (I2 = 92.90%, P < 0.001). For the subgroup of six studies (N = 23, 155) with 1-year follow-up, the pooled mortality rate was 13% (95% CI: 9%–17%) with high heterogeneity (I2 = 91.60%, P < 0.001). This may be due to differences in the age range of the included study subjects or large differences in the sample size. For two studies (N = 1, 674) with 2-year follow-up, the pooled mortality rate was 9% (95% CI: 6%–12%) with low heterogeneity (I2 = 0.00%, P = 0.529).
Obesity
The pooled analysis result from five studies (N = 6, 739) in [Table 3] showed that obesity (OR = 0.41, 95% CI: 0.16–1.04, I2 = 82.80%, P = 0.061, PAF = 2.9%) did not reach statistical significance. The pooled mortality rate for obesity STEMI patients after PCI was 5% (95% CI: 3%–8%) with high heterogeneity (I2 = 92.80%, P < 0.001).
Smoking
The pooled analysis result from two articles (N = 3, 515) in [Table 3] showed that smoking (OR = 0.90, 95% CI: 0.64–1.28, I2 = 0.00%, P = 0.563, PAF = 0.3%) did not reach statistical significance. The pooled 30-day mortality rate for smoking STEMI patients after PCI was 3% (95% CI: 0%–7%) with high heterogeneity (I2 = 93.90%, P < 0.001).
Out-of-hospital cardiac arrest
Across three studies (N = 15, 054) in [Table 3] reported out-of-hospital cardiac arrest (OHCA) was a risk factor (OR = 5.55, 95% CI: 2.58–11.94, I2 = 87.10%, P < 0.001, PAF = 58.5%) of mortality for STEMI patients after PCI. The pooled mortality rate after PCI for STEMI patients with OHCA was 31% (95% CI: 21%–41%) with medium heterogeneity (I2 = 74.90%, P = 0.019). In a subgroup of two studies (N = 14, 287) with 30-day follow-up, the pooled mortality rate was 25% (95% CI: 1%–49%) with significant heterogeneity (I2 = 95.60%, P < 0.001). For the subgroup of two studies (N = 2, 417) with 1-year follow-up, the pooled mortality rate was 27% (95% CI: 12%–42%) with insignificant heterogeneity (I2 = 72.20%, P = 0.058).
Elevated hemoglobin A1c level
Across two studies (N = 1, 239) in [Table 3] reported elevated hemoglobin A1c (Hb1Ac) level (≥6.5 mmol/L) was a risk factor (OR = 4.53, 95% CI: 0.52–39.46, I2 = 95.20%, P = 0.171, PAF = 43.7%) of mortality for STEMI patients after PCI. The pooled mortality rate after PCI for STEMI patients with elevated Hb1Ac levels was 22% (95% CI: 6%–50%) with high heterogeneity (I2 = 97.90%, P < 0.001).
Cardiogenic shock
Across two studies (N = 8, 386) in [Table 3] reported cardiogenic shock (CS) was a risk factor (OR = 4.83, 95% CI: 3.71–6.29, I2 = 92.5%, P < 0.001, PAF = 56.6%) of mortality for STEMI patients after PCI. The pooled mortality rate after PCI for STEMI patients with CS was 34% (95% CI: 13%–81%) with high heterogeneity (I2 = 99.00%, P < 0.001).
Renal dysfunction
Across four studies (N = 4, 935) in [Table 3] reported renal dysfunction (RD) was a risk factor (OR = 3.50, 95% CI: 1.56–7.84, I2 = 89.90%, P = 0.002, PAF = 32.2%) of mortality for STEMI patients after PCI. The pooled mortality rate after PCI for STEMI patients with RD was 19% (95% CI: 5%–33%) with high heterogeneity (I2 = 97.70%, P < 0.001). In a subgroup of two studies (N = 1, 744) with estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2, the pooled mortality rate was 26% (95% CI: 22%–30%) with low heterogeneity (I2 = 33.00%, P = 0.222). For the subgroup of two studies (N = 3, 191) with RD definition of serum creatinine level ≥ 115 μmol/L, the pooled mortality rate was 9% (95% CI: 2%–20%) with high heterogeneity (I2 = 87.10%, P = 0.005).
Admission anemia
Across three studies (N = 3, 680) in [Table 3] reported admission anemia was a risk factor (OR = 3.28, 95% CI: 2.57–4.18, I2 = 0.00%, P < 0.001, PAF = 36.3%) of mortality for STEMI patients after PCI. The pooled mortality rate after PCI for STEMI patients with admission anemia was 25% (95% CI: 13%–28%) with high heterogeneity (I2 = 90.50%, P < 0.001).
Hyperuricemia
Across two studies (N = 1, 045) in [Table 3] reported hyperuricemia was a risk factor (OR = 2.71, 95% CI: 1.67–4.39, I2 = 44.90%, P < 0.001, PAF = 17.0%) of mortality for STEMI patients after PCI. The pooled mortality rate for hyperuricemia STEMI patients after PCI was 12% (95% CI: 8%–15%) with high heterogeneity (I2 = 0.00%, P = 0.473).
Elevated blood glucose level
Across three studies (N = 2, 112) in [Table 3] reported elevated blood glucose level (≥7.8 mmol/L) was a risk factor (OR = 2.56, 95% CI: 1.98–3.04, I2 = 0.00%, P < 0.001, PAF = 39.6%) of mortality for STEMI patients after PCI. The pooled mortality rate for exposure group patients was 42% (95% CI 11%–74%) with high heterogeneity (I2 = 98.80%, P < 0.001). In a subgroup of two studies (N = 1, 854) with 30-day follow-up, the pooled mortality rate was 26% (95% CI: 4%–56%) with significant heterogeneity (I2 = 98.20%, P < 0.001). For the subgroup of two studies (N = 466) with 1-year follow-up, the pooled mortality rate was 48% (95% CI: 43%–54%) with insignificant heterogeneity (I2 = 38.70%, P = 0.202).
Diabetes mellitus
Across four studies (N = 6, 222) in [Table 3] reported diabetes mellitus (DM) was a risk factor (OR = 2.00, 95% CI: 1.62–2.46, I2 = 0.00%, P < 0.001, PAF = 10.7%) of mortality for STEMI patients after PCI. The pooled mortality rate after PCI for STEMI patients with DM was 12% (95% CI: 6%–18%) with high heterogeneity (I2 = 89.80%, P < 0.001). In a subgroup of four studies (N = 6, 222) with 30-day follow-up, the pooled mortality rate was 9% (95% CI: 3%–14%) with significant heterogeneity (I2 = 88.40%, P < 0.001). For the subgroup of two studies (N = 5, 245) with 3-year follow-up, the pooled mortality rate was 15% (95% CI: 7%–22%) with significant heterogeneity (I2 = 85.10%, P = 0.01).
Elevated heart rate
Across two studies (N = 4, 689) in [Table 3] reported elevated heart rate was a risk factor of mortality for STEMI patients after PCI. However, a meta-analysis could not be conducted due to differences in grouping criteria. One study was based on previous studies in populations with various cardiovascular diseases including postprimary PCI,[19] while the other did not mention the basis for the classification.
Elevated ratio of neutrophils to lymphocytes
Across four studies (N = 4, 045) in [Table 3] reported elevated neutrophils to lymphocytes (NLR) was a risk factor of mortality for STEMI patients after PCI. NLR was calculated as the ratio of NLR. However, the grouping criteria of the four studies were different, and the basis of grouping was not clearly mentioned. Therefore, we compare with grouping criteria of NLR according to mortality for STEMI patients after PCI [Figure 4]. | Figure 4: Comparison of grouping criteria of NLR according to mortality. NLR = neutrophils to lymphocytes
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Chronic total occlusion
Across two studies (N = 1, 043) in [Table 3] reported chronic total occlusion (CTO) was a risk factor (OR = 3.03, 95% CI: 2.08–4.41, I2 = 2.80%, P < 0.001, PAF = 28.9%) of mortality for STEMI patients after PCI. The pooled mortality rate after PCI for STEMI patients with CTO was 20% (95% CI: 11%–30%) with high heterogeneity (I2 = 81.00%, P = 0.022).
Q wave on presentation
Across three studies (N = 7, 922) in [Table 3] reported Q wave on presentation was a risk factor (OR = 2.18, 95% CI: 1.74–2.73, I2 = 17.30%, P < 0.001, PAF = 7.6%) of mortality for STEMI patients after PCI. The pooled mortality rate after PCI for STEMI patients with Q wave on presentation was 7% (95% CI: 5%–9%) with medium heterogeneity (I2 = 73.90%, P = 0.022). In a subgroup of two studies (N = 7, 253) with 30-day follow-up, the pooled mortality rate was 4% (95% CI: 2%–5%) with significant heterogeneity (I2 = 83.30%, P = 0.014). For the subgroup of two studies (N = 3, 392) with 1-year follow-up, the pooled mortality rate was 6% (95% CI: 3%–9%) with medium heterogeneity (I2 = 74.50%, P = 0.048). This may be the reason for the large heterogeneity caused by the large difference in sample size.
Without prodromal angina
Across two studies (N = 6, 491) in [Table 3] reported without prodromal angina (PA) was a risk factor (OR = 2.12, 95% CI: 1.58–2.85, I2 = 51.90%, P < 0.001, PAF = 16.0%) of mortality for STEMI patients after PCI. The pooled mortality rate after PCI for STEMI patients without PA was 17% (95% CI: 13%–22%) with high heterogeneity (I2 = 95.10%, P < 0.001).
Delay in door-to-balloon time
Delay in DTB time was a risk factor (OR = 1.72, 95% CI: 1.47–2.01, I2 = 5.30%, P < 0.001, PAF = 4.8%) we retrieved from six articles (N = 17, 501) in this study [Table 3]. The pooled mortality rate for STEMI patients after PCI at the delay in DTB time was 7% (95% CI: 5%–9%) with high heterogeneity (I2 = 91.70%, P < 0.001). In a subgroup of two studies (N = 5, 802) with a delay in DTB time definition at or above 45 min (OR = 1.42, 95% CI: 0.66–3.02, I2 = 58.40%, P = 0.367, PAF = 2.5%), the pooled mortality rate was 6% (95% CI: 3%–10%) with high heterogeneity (I2 = 89.40%, P = 0.002). For the subgroup of five studies (N = 12, 781) with delay in DTB time definition at or above 60 min (OR = 1.72, 95% CI: 1.45–2.03, I2 = 17.70%, P < 0.001, PAF = 5.4%), the pooled mortality rate was 8% (95% CI: 5%–12%) with high heterogeneity (I2 = 94.00%, P < 0.001). The high heterogeneity could be explained by the variation of follow-up period, the pooled mortality rate for four studies (N = 7, 538) with 30-day follow-up was 7% (95% CI: 4%–10%) with significant heterogeneity (I2 = 87.20%, P < 0.001), while the pooled mortality rate for two studies (N = 6, 132) with 1-year follow-up was 9% (95% CI: 8%–10%) with low heterogeneity (I2 = 0.00%, P = 0.786). For the remaining three studies (N = 16, 080) with delay in DTB time definition at or above 90 min (OR = 1.92, 95% CI: 1.20–3.09, I2 = 89.40%, P = 0.007, PAF = 7.6%), the pooled mortality rate was 9% (95% CI: 5%–12%) with high heterogeneity (I2 = 95.40%, P < 0.001).
Delay in symptom onset-to-balloon time
Across four studies (N = 11, 353) in [Table 3] reported delay in symptom onset-to-balloon time (STB) time was a risk factor (OR = 1.43, 95% CI: 1.18–1.72, I2 = 0.00%, P < 0.001, PAF = 2.1%) of mortality for STEMI patients after PCI. The pooled mortality rate for STEMI patients after PCI at the delay in STB time was 5% (95% CI: 4%–6%) with low heterogeneity (I2 = 63.20%, P = 0.043). In a subgroup of three studies (N = 10, 834) with delay in STB time definition at or above 3 h (OR = 1.43, 95% CI: 1.17–1.76, I2 = 0.00%, P = 0.001, PAF = 2.1%), the pooled mortality rate was 5% (95% CI, 4%–5%) with low heterogeneity (I2 = 0.00%, P = 0.531). Different studies involved the variation of the follow-up period, the pooled mortality rate for three studies (N = 10, 834) with 30-day follow-up was 4% (95% CI, 3%–5%) with low heterogeneity (I2 = 29.70%, P = 0.241), while the pooled mortality rate for two studies (N = 10, 275) with 90-day follow-up was 5% (95% CI, 4%–5%) with low heterogeneity (I2 = 0.00%, P = 0.485). For the subgroup of two studies (N = 1, 452) with delay in STB time definition at or above 4 h (OR = 1.55, 95% CI: 1.00–2.39, I2 = 0.00%, P = 0.048, PAF = 3.7%), the pooled mortality rate was 7% (95% CI, 4%–11%) with low heterogeneity (I2 = 61.40%, P = 0.108).
Anterior infarction
Across three studies (N = 7, 292) in [Table 3] reported anterior infarction was a risk factor (OR = 1.66, 95% CI: 1.46–1.90, I2 = 0.00%, P < 0.001, PAF = 18.3%) of mortality for STEMI patients after PCI. The pooled mortality rate for anterior infarction STEMI patients after PCI was 34% (95% CI: 0%–74%) with high heterogeneity (I2 = 99.80%, P < 0.001). In the group of three studies (N = 7, 292) with 30-day follow-up, the pooled mortality rate was 30% (95% CI: 0%–65%) with significant heterogeneity (I2 = 99.70%, P < 0.001). For the subgroup of two studies (N = 7, 080) with 1-year follow-up, the pooled mortality rate was 35% (95% CI: 0%–86%) with significant heterogeneity (I2 = 99.90%, P < 0.001). This may be the reason for the large heterogeneity caused by the large difference in sample size.
ST-segment resolution
Across four studies (N = 4, 958) in [Table 3] reported ST-segment resolution (STR) (≤70%) was a risk factor (OR = 1.40, 95% CI: 1.12–1.75, I2 = 43.10%, P = 0.003, PAF = 3.5%) of mortality for STEMI patients after PCI. The pooled mortality rate for exposure group patients was 9% (95% CI: 6%–12%) with high heterogeneity (I2 = 80.80%, P = 0.001). In a subgroup of two studies (N = 3, 835) with 3-year follow-up, the pooled mortality rate was 7% (95% CI, 6%–8%) with low heterogeneity (I2 = 46.10%, P = 0.173). For the subgroup of two studies (N = 2, 251) with 5-year follow-up, the pooled mortality rate was 10% (95% CI, 5%–14%) with high heterogeneity (I2 = 85.70%, P = 0.008). Other confounding factors may affect heterogeneity due to the long follow-up time.
Delay in symptom onset-to-door time
Across two studies (N = 10, 335) in [Table 3] reported delay in symptom onset-to-door time (STD) time longer than 2 h was a risk factor (OR = 1.29, 95% CI: 1.10–1.51, I2 = 0.00%, P = 0.002, PAF = 2.0%) of mortality for STEMI patients after PCI. The pooled mortality rate for exposure group patients was 7% (95% CI: 5%–9%) with high heterogeneity (I2 = 88.90%, P = 0.003).
Off-hour operation
Across four studies (N = 11, 618) in [Table 3] reported off-hour operation was a risk factor (OR = 1.11, 95% CI: 1.00–1.24, I2 = 0.00%, P = 0.053, PAF = 1.2%) of mortality for STEMI patients after PCI. The pooled mortality rate for exposure group patients was 11% (95%CI: 4%–18%) with high heterogeneity (I2 = 98.80%, P < 0.001). In a subgroup of two studies (N = 4, 090) with 1-year follow-up, the pooled mortality rate was 7% (95% CI: 2%–11%) with high heterogeneity (I2 = 93.80%, P < 0.001). For the subgroup of two studies (N = 8, 374) with 3-year follow-up, the pooled mortality rate was 14% (95% CI: 1%–29%) with high heterogeneity (I2 = 99.50%, P < 0.001).
Discussion | |  |
Being 45 or older and female increased the risk of mortality after percutaneous coronary intervention for ST-elevation myocardial infarction patients
Our study reported that mortality prevalence increased with age criteria and follow-up criteria for grouping. STEMI patients at or above 80 years old after PCI held the highest mortality rate at 32%. This may have something to do with the elderly, who have multiple chronic comorbidities, and their basic cardiac functions were worse.[20] Moreover, when the follow-up period was taken into account, the 1-year mortality rate was higher than the 30-day mortality rate, and the 1-year mortality rate for STEMI patients after PCI at or above 80 was the highest at 27%, similar to previous findings.[21],[22] However, it was slightly lower than Christiansen's study result,[23] which showed that the 1-year mortality rate for American STEMI patients after PCI at or above 80 was 25.6%. This may be related to the deterioration of body functions with complications, leading to slow postoperative recovery and the increased risk of noncardiac death in elderly STEMI patients after PCI with the extension of follow-up time. Therefore, it is indicated that patients aged at or over 45 years are already at risk, and risk assessment before PCI treatment, targeted preoperative preparation, and regular follow-up for at least 1 year after surgery should be carried out actively to prevent adverse events, especially for STEMI patients at or over 80 years old.
The results of the meta-analysis showed that female was a risk factor for STEMI patients after PCI, and the mortality in female patients within 1 year after PCI was higher than that in more than 1 year, which was consistent with Stone's study results.[24] The symptoms of female STEMI patients are often atypical, it is likely to miss the best time for treatment due to ignorance, which leads to the relatively severe condition compared with men patients and prolonged recover time after PCI.[25],[26],[27] Therefore, it is suggested that health education and transitional care for female patients after PCI should be strengthen, especially how to identify dangerous signs timely and carry forward follow-up examinations regularly.
Complicated with out-of-hospital cardiac arrest, cardiogenic shock, renal dysfunction, admission anemia, hyperuricemia, blood glucose level ≥7.8 mmol/L, and diabetes mellitus increased the risk of mortality after percutaneous coronary intervention for ST-elevation myocardial infarction patients
This study evidenced the greatest risk of mortality after PCI for STEMI patients complicated with OHCA (OR = 5.55). As one of the most dangerous complications, OHCA can seriously affect the prognosis of patients significantly.[28],[29] Previous studies have reported that poor nervous system recovery associated with the prolonged recovery time of spontaneous circulation and myocardial dysfunction associated with ischemic load influenced the short-term prognosis of patients,[30],[31] which may also explain why the association between OHCA and mortality is higher at 30 days than at 1 year. Therefore, it is suggested that patients can achieve more significant benefits from effective medical treatment aimed to shorten the aid and transport time and restore spontaneous circulation as soon as possible.
The results of the meta-analysis showed that CS was significantly associated with mortality after PCI in this study, but pooled mortality in the CS group was much higher (25%) than unexposure group. The fundamental reason may be the difference in clinical manifestation between the two groups. Compared with patients without CS, the angiographic performance of CS patients is more serious, for example, they are often diagnosed with multivessel coronary disease, and the percentage of left anterior descending artery disease is much higher (50%–79%).[32],[33] In addition, baseline TIMI 0-1 blood flow is more likely to occur (62%) in infarct-related arteries.[33] Patients with CS are prone to no reflow, and their infarct-related arteries are more likely to be completely blocked for a longer time, resulting in microvascular dysfunction very quickly.[34],[35] This finding indicates that early rescue and effective treatment regimens are crucial for STEMI patients complicated with CS to improve the survival rate.
As an important factor reflecting vascular physiological abnormalities, renal function affect the occurrence of cardiovascular adverse events significantly.[28],[29] In the sense that it is important to establish criteria for RD. This study evidenced the significant risk of mortality after PCI for STEMI patients complicated with renal dysfunction (OR = 5.32) when eGFR was used as the indicator and calculated with the modification of diet in the renal disease equation. More specially, angiography is required during PCI, and the contrast agent itself may cause damage to renal function.[36] Therefore, this finding evidenced the risk of RD and emphasizes the preventative role that continuous monitoring of renal function, prudent use of nephrotoxic drugs, and practical guidance on the excretion of contrast agents may have in terms of mortality after PCI.
Admission anemia was significantly associated with mortality after PCI for STEMI patients in this study. The chronic state of admission anemia may cause hemodynamic adaptation, which has a significant impact on microvascular remodeling and atherosclerosis. Previous studies[37],[38] have showed that anemia of chronic disease can lead to decreased blood viscosity accompanied by decreased afterload, and eventually result in failure and death. Although the significant heterogeneity may have been due to differences in follow-up time, which varied from 1 year to 6 years across included three studies, mortality increased along with prolonged follow-up time in three included studies. This finding has established that the active prevention and correction of anemia in STEMI patients before PCI can reduce the risk of death and improve long-term outcomes.
Hyperuricemia was significantly associated with mortality after PCI for STEMI patients in this study. However, included studies in this meta-analysis indicated that mortality decreased with prolonged follow-up time from 11.7% at 1 year to 7% at 7.3 years.[39],[40] Such findings suggest that patients with hyperuricemia should strongly be considering for active control of uric acid levels before PCI and regular detection of uric acid levels after PCI. Meanwhile, dietary guidance is necessary for patients and their co-residents, so as to effectively control purine intake.
DM and blood glucose levels ≥7.8 mmol/L (hyperglycemia) were significantly associated with mortality after PCI for STEMI patients in this study, and blood glucose level ≥7.8 mmol/L (OR = 2.56) demonstrated a greater risk than DM (OR = 2.00). More specially, DM and blood glucose levels are highly correlated. DM patients are in a state of hyperglycemia for a long time, previous studies[41],[42] have shown that hyperglycemia can increase the tendency for blood clots to form and cytokines to release, thus lead to endothelial dysfunction and oxidative stress, and eventually aggravate myocardial injury. Moreover, results showed that 1-year mortality in STEMI patients after PCI with hyperglycemia was highest (48%), mortality increased along with prolonged follow-up time in both the exposure group and unexposure group for patients with DM or hyperglycemia, while OR decreased along with prolonged follow-up time. There are two aspects of this finding that need to deserve some explanation. On the one hand, this finding indicated the actual effect that would be expected to be prevented following the elimination of exposure to DM or hyperglycemia, which was consistent with trends in PAF. On the other hand, studies[43] have shown that a large proportion of STEMI patients experience glucose intolerance during acute events, but over time, the symptoms of glucose intolerance in some patients will be alleviated, which may be the reason why the association became progressively weaker with prolonged follow-up time. Therefore, it is important to keep the preoperative blood glucose under control to improve the prognosis of patients, regardless of whether or not they have diabetes.
The manifestation and feature of chronic total occlusion, Q wave on presentation, without prodromal angina, delay in door-to-balloon time, delay in symptom onset-to-balloon time, anterior infarction, ST-segment resolution ≤70%, and delay in symptom onset-to-door time increased the risk of mortality after percutaneous coronary intervention for ST-elevation myocardial infarction patients
CTO, as the most challenging form of PCI, has received more and more clinical attention. Previous reports[44],[45] of non-IRA CTO, in particular, have been demonstrated higher short-term and long-term mortality, which was consistent with this study. This relationship is known to be robust[46] and constitutes the basis for guideline recommendations promoting CTO-PCI with aggressive attempts involving dissection techniques and retrograde collateral channel crossing.[47] In this study, only two studies with 1-year follow-up were synthesized, and the pooled risk was lower compared with a previous meta-analysis,[48] which reported a pooled OR of 3.76 at 30 days and 2.9 at a median follow-up of 25.2 months. The inconsistency regarding the trends of the relationship between the occurrence of non-IRA CTO and mortality after PCI for STEMI patients, at least in part, from the exclusion of patients with prior PCI and prior MI in this study.
In this study, STR and Q wave on presentation were significant electrocardiography manifestations associated with mortality after PCI for STEMI patients. Prior studies[46],[49] have shown that ST-segment monitoring after PCI is a widely available, well-validated, noninvasive tool to reflect effective perfusion of myocardial tissue and microvascular integrity. However, research on the relationship between the extent of STR and clinical outcomes, particularly long-term outcomes, have been inconsistent.[46],[49],[50] The uncertainty stems at least in part from the different methods they used for quantifying and categorizing STR. Included studies with the same grouping criteria for STR extent, this study evidenced the robust relationship between STR and long-term mortality for STEMI patients. In addition, subgroup meta-analysis results showed a stronger association between STR and 5-year mortality than 3-year mortality. However, moderate heterogeneity, possible concurrency problems from the differences in the measured time of STR in the original literature, indicates the results may not reliable and future research may benefit from expanding the samples' quantity and defining the measured time of STR so as to more robustly test the association. Q wave on presentation, as a physiological indicator of the development stage of infarction, indicates a broader myocardial invasion. Studies[51] have demonstrated that patients with Q wave on presentation were much less likely to reach the appropriate STR immediately after PCI when compared with patients without Q wave, resulting in higher mortality. Moreover, the subgroup meta-analysis results showed that the correlation between Q wave on presentation and mortality was higher at 30 days than 1 year, suggesting that Q wave may have a significant influence on the short-term prognosis. At last, based on the points discussed above, the combined application of Q wave to predict short-term mortality and STR to predict long-term mortality can be strongly practical with the evidence of definite measure time and method.
The symptom of PA was significantly associated with mortality after PCI for STEMI patients in this study. The analyzed data indicated that the prevalence of mortality was lower among patients with symptoms of PA (9%) than among those without (17%). The difference may result from enhanced myocardial endurance by ischemic preconditioning, the establishment of collateral circulation, and accelerated coagulation lysis by thrombolytic substances accompanying angina before infarction.[52] Murry[53] reported that the transient, nonfatal myocardial ischemic attack made the heart preconditioned and greatly reduced the infarction area, and proposed the concept of “preconditioned effect.” Therefore, PA does not only mean the occurrence of the disease but may have a positive effect on the prognosis. It is a well-worth effort to introduce the warning role of PA as the end result will be much more timely and effective treatment.
The current analysis documented several interval metrics, delay in the STD, DTB, and STB time, constituted risk factors for mortality after PCI for STEMI patients. Previous studies[54],[55],[56] have demonstrated that delay in the STD time, DTB time, and STB time was significantly associated with mortality, and the correlates constitute the basis for guideline recommendations shortening of DTB time to within 90 min.[57] The subgroup analysis of DTB time also indicated the strongest protective effect of mortality when STEMI patients were treated with PCI within 90 min upon arrival at the hospital. However, it is estimated that nearly 90% of patients have a DTB duration of 90 min[58] currently. The delay may result from the deficiency of associated knowledge, inconvenience of hospital visits, and inadequate emergency system. Studies have shown that the time of STD has remained relatively stable in recent years. In this study, the protective effect of STD time with grouping criteria of 2 h was the lowest, compared with DTB time or STB time with any grouping criteria. STB time, the sum of STD time and DTB time, was a valid measure of the efficiency of a health-care system, and the protective effect of STB time with grouping criteria of 3 h was lower than that with grouping criteria of 4 h.
The meta-analysis results showed that the prevalence of mortality was higher among patients with anterior infarction (34%) than among those with nonanterior infarction (27%). It was demonstrated that the anterior wall was the place where the heart contracts most powerfully, and patients with anterior infarction were at greater risk of infarction area dilatation, and the more vessels involved, the more likely it was to cause CS, leading to poor prognosis.[32],[59] Consistent with these results, this study has well established that anterior infarction was significantly associated with mortality after PCI for STEMI patients (OR = 1.66). Moreover, the subgroup meta-analysis results showed that the correlation between anterior infarction and mortality was higher at 30 days than at 1 year, suggesting that anterior infarction may have a significant influence on the short-term prognosis. Studies[60] have proved that an electrocardiogram was of great value in the diagnosis of acute myocardial infarction, and clinicians need to carefully analyze the characteristics of electrocardiogram, so as to predict the infarct-related arteries of acute myocardial infarction well. In addition, the combination of coronary angiography results can better select vessels requiring emergency intervention, provide more accurate information for early treatment and prognosis assessment, and strengthen specialized medical care to improve the long-term prognosis of patients.
Strengths and limitations
A fundamental strength of the current analysis is the adoption of robust methodology. Nine electronic databases were searched systematically to identify relevant articles. This extensive effort, undertaken by two reviewers, enhanced the ability to accurately catalog the entire information on associated factors of mortality among STEMI patients after PCI and allowed stratifying the studies based on the degree of controlling for grouping criteria or follow-up time. However, the potential limitations of this study should be noted. First, the differences in the measurement of exposure factors and the definition of outcome indicators among different studies may become one of the sources of heterogeneity. Second, the review gathered 91 cohorts, but each analysis was based on 2 to 15 studies. Although a small number of studies were included in each index, the sample size was large and did not affect the outcome of the research results. Third, further analysis of some risk factors as described in the protocol, such as sensitive analysis and meta-regression, was not conducted to explore sources of heterogeneity due to the small number of studies on individual risk factors. Fourth, some eligible studies published in other languages were excluded due to the language filter, which limited the comprehensiveness of this study. In view of the limitations of this study, more high-quality studies are needed to verify the above conclusions.
Conclusions | |  |
To sum up, this systematic review found that the pooled mortality rate after PCI for STEMI patients was 10%. Such a high prevalence indicates the urgent need for controlling associated factors: Advanced age, female, OHCA, CS, RD, admission anemia, hyperuricemia, blood glucose level ≥7.8 mmol/L and DM, CTO, Q wave on presentation, without PA, delay in DTB time, delay in STB time, anterior infarction, STR ≤70%, and delay in STD time.
Among the factors above, modifiable factors include blood glucose level, RD, hyperuricemia, DM, STD time, DTB time, and STB time, which lead to the interventions for reasonable lifestyle, good medication compliance, and correct first aid knowledge to improve the outcome for STEMI patients after PCI. This research can provide a theoretical basis for the prevention of mortality after PCI for STEMI patients.[135]
Financial support and sponsorship
- National Nature Science Foundation of China (71704071, 72274087)
- The National Social Science Fund of China (20CGL053)
- China Medical Board (Gant #20-374)
- Nature Science Foundation of Gansu Province (20JR10RA603)
- The Fundamental Research Funds for the Central Universities (lzujbky-2020-10, lzujbky-2021-33)
- 2020 Research project of School of Nursing, Lanzhou University (LZUSON202008)
- 2022 Undergraduate Education and Teaching Development Project of the School of Nursing, Lanzhou University.
Conflicts of interest
There are no conflicts of interest.
References | |  |
1. | Li J, Li X, Wang Q, Hu S, Wang Y, Masoudi FA, et al. ST-segment elevation myocardial infarction in China from 2001 to 2011 (the China PEACE-retrospective acute myocardial infarction study): A retrospective analysis of hospital data. Lancet 2015;385:441-51. |
2. | Tanik VO, Cinar T, Arugaslan E, Karabag Y, Hayiroglu MI, Cagdas M, et al. The predictive value of PRECISE-DAPT score for in-hospital mortality in patients with st-elevation myocardial infarction undergoing primary percutaneous coronary intervention. Angiology 2019;70:440-7. |
3. | Zijlstra F, Hoorntje JC, de Boer MJ, Reiffers S, Miedema K, Ottervanger JP, et al. Long-term benefit of primary angioplasty as compared with thrombolytic therapy for acute myocardial infarction. N Engl J Med 1999;341:1413-9. |
4. | Widimsky P, Wijns W, Fajadet J, de Belder M, Knot J, Aaberge L, et al. Reperfusion therapy for ST elevation acute myocardial infarction in Europe: Description of the current situation in 30 countries. Eur Heart J 2010;31:943-57. |
5. | McManus DD, Gore J, Yarzebski J, Spencer F, Lessard D, Goldberg RJ. Recent trends in the incidence, treatment, and outcomes of patients with STEMI and NSTEMI. Am J Med 2011;124:40-7. |
6. | Jernberg T, Johanson P, Held C, Svennblad B, Lindbäck J, Wallentin L, et al. Association between adoption of evidence-based treatment and survival for patients with ST-elevation myocardial infarction. JAMA 2011;305:1677-84. |
7. | Casella G, Ottani F, Ortolani P, Guastaroba P, Santarelli A, Balducelli M, et al. Off-hour primary percutaneous coronary angioplasty does not affect outcome of patients with ST-segment elevation acute myocardial infarction treated within a regional network for reperfusion: The REAL (registro regionale angioplastiche dell'emilia-romagna) registry. JACC Cardiovasc Interv 2011;4:270-8. |
8. | Zhang B, Jiang DM, Sun YJ, Ren LN, Zhang ZH, Gao Y, et al. The role of gender difference on the prognosis of ST-segment elevation myocardial infarction (STEMI) in patients treated with primary percutaneous coronary intervention. Zhonghua Liu Xing Bing Xue Za Zhi 2012;33:92-8. |
9. | Gao M, Zhao W, Zhang Z, Qin L, Zhang W, Zheng Y. Clinical characteristics and outcomes in young patients with ST-segment elevation myocardial infarction after primary percutaneous coronary intervention. Am J Med Sci 2018;355:544-52. |
10. | Karamfiloff K, Vassilev D, Staneva M, Vladimirova L, Stoykova J. Influence of gender on mortality in patients with st-elevation acute myocardial infarction treated with primary percutaneous coronary intervention – Single high volume centre experience. C R Acad Bulg Sci 2015;68:795-800. |
11. | Ekmekci A, Uluganyan M, Tufan F, Uyarel H, Karaca G, Kul S, et al. Impact of admission blood glucose levels on prognosis of elderly patients with ST elevation myocardial infarction treated by primary percutaneous coronary intervention. J Geriatr Cardiol 2013;10:310-6. |
12. | Chen FC, Lin YR, Kung CT, Cheng CI, Li CJ. The association between door-to-balloon time of less than 60 minutes and prognosis of patients developing ST segment elevation myocardial infarction and undergoing primary percutaneous coronary intervention. Biomed Res Int 2017;2017:1-6. |
13. | Pedersen F, Butrymovich V, Kelbæk H, Wachtell K, Helqvist S, Kastrup J, et al. Short and long-term cause of death in patients treated with primary PCI for STEMI. J Am Coll Cardiol 2014;64:2101-8. |
14. | Nair NS, Lewis LE, Lakiang T, Godinho M, Murthy S, Venkatesh BT. Factors associated with mortality due to neonatal pneumonia in India: A protocol for systematic review and planned meta-analysis. BMJ Open 2017;7:e017616. |
15. | Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, et al. Meta-analysis of observational studies in epidemiology: A proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA 2000;283:2008-12. |
16. | Yan F, Liu H, Jiang W. Prevalence and associated factors of mortality after percutaneous coronary intervention for adult patients with ST elevation myocardial infarction: A systematic review and meta-analysis protocol. Medicine (Baltimore) 2019;98:e16226. |
17. | Tomaszuk-Kazberuk A, Kożuch M, Małyszko J, Bachórzewska-Gajewska H, Kosacka U, Dobrzycki S, et al. Do overweight patients have a better five years prognosis after an acute myocardial infarction treated with coronary intervention? Kardiol Pol 2012;70:686-93. |
18. | Her AY, Shin ES, Kim YH, Garg S, Jeong MH. The contribution of gender and age on early and late mortality following ST-segment elevation myocardial infarction: Results from the Korean acute myocardial infarction national registry with registries. J Geriatr Cardiol 2018;15:205-14. |
19. | Noman A, Balasubramaniam K, Das R, Ang D, Kunadian V, Ivanauskiene T, et al. Admission heart rate predicts mortality following primary percutaneous coronary intervention for ST-elevation myocardial infarction: An observational study. Cardiovasc Ther 2013;31:363-9. |
20. | Guo F, Wang X, Li G, Chen X, Fan J. Primary percutaneous coronary intervention on older patients with acute ST-segment elevation myocardial infarction: Analysis of its risk factors. J Med Coll PLA 2010;25:29-37. |
21. | Zhou Z. Analysis of related factors influencing the short-term prognosis of direct PCI in elderly STEMI patients. Zhejiang Clin Med 2017;19:1225-7. |
22. | Claessen BE, Kikkert WJ, Engstrom AE, Hoebers LP, Damman P, Vis MM, et al. Primary percutaneous coronary intervention for ST elevation myocardial infarction in octogenarians: Trends and outcomes. Heart 2010;96:843-7. |
23. | Christiansen EH, Jensen LO, Thayssen P, Tilsted HH, Krusell LR, Hansen KN, et al. Biolimus-eluting biodegradable polymer-coated stent versus durable polymer-coated sirolimus-eluting stent in unselected patients receiving percutaneous coronary intervention (SORT OUT V): A randomised non-inferiority trial. Lancet 2013;381:661-9. |
24. | Stone SG, Serrao GW, Mehran R, Tomey MI, Witzenbichler B, Guagliumi G, et al. Incidence, predictors, and implications of reinfarction after primary percutaneous coronary intervention in ST-segment-elevation myocardial infarction: The harmonizing outcomes with revascularization and stents in acute myocardial infarction trial. Circ Cardiovasc Interv 2014;7:543-51. |
25. | Sederholm Lawesson S, Isaksson RM, Ericsson M, Ängerud K, Thylén I, SymTime Study Group. Gender disparities in first medical contact and delay in ST-elevation myocardial infarction: A prospective multicentre Swedish survey study. BMJ Open 2018;8:e020211. |
26. | Kirchberger I, Heier M, Kuch B, Wende R, Meisinger C. Sex differences in patient-reported symptoms associated with myocardial infarction (from the population-based MONICA/KORA myocardial infarction registry). Am J Cardiol 2011;107:1585-9. |
27. | Lichtman JH, Leifheit EC, Safdar B, Bao H, Krumholz HM, Lorenze NP, et al. Sex differences in the presentation and perception of symptoms among young patients with myocardial infarction: Evidence from the VIRGO study (variation in recovery: Role of gender on outcomes of young AMI patients). Circulation 2018;137:781-90. |
28. | Fathi RB, Gurm HS, Chew DP, Gupta R, Bhatt DL, Ellis SG. The interaction of vascular inflammation and chronic kidney disease for the prediction of long-term death after percutaneous coronary intervention. Am Heart J 2005;150:1190-7. |
29. | Schiffrin EL, Lipman ML, Mann JF. Chronic kidney disease: Effects on the cardiovascular system. Circulation 2007;116:85-97. |
30. | Stub D, Bernard S, Duffy SJ, Kaye DM. Post cardiac arrest syndrome: A review of therapeutic strategies. Circulation 2011;123:1428-35. |
31. | Myat A, Song KJ, Rea T. Out-of-hospital cardiac arrest: Current concepts. Lancet 2018;391:970-9. |
32. | Tsai TH, Chai HT, Sun CK, Leu S, Fan CQ, Zhang ZH, et al. Comparison of 30-day mortality between anterior-wall versus inferior-wall ST-segment elevation myocardial infarction complicated by cardiogenic shock in patients undergoing primary coronary angioplasty. Cardiology 2010;116:144-50. |
33. | Webb JG, Lowe AM, Sanborn TA, White HD, Sleeper LA, Carere RG, et al. Percutaneous coronary intervention for cardiogenic shock in the SHOCK trial. J Am Coll Cardiol 2003;42:1380-6. |
34. | Mehta RH, Ou FS, Peterson ED, Shaw RE, Hillegass WB Jr., Rumsfeld JS, et al. Clinical significance of post-procedural TIMI flow in patients with cardiogenic shock undergoing primary percutaneous coronary intervention. JACC Cardiovasc Interv 2009;2:56-64. |
35. | Niccoli G, Burzotta F, Galiuto L, Crea F. Myocardial no-reflow in humans. J Am Coll Cardiol 2009;54:281-92. |
36. | Sabroe JE, Thayssen P, Antonsen L, Hougaard M, Hansen KN, Jensen LO. Impact of renal insufficiency on mortality in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention. BMC Cardiovasc Disord 2014;14:15. |
37. | Kalra PR, Greenlaw N, Ferrari R, Ford I, Tardif JC, Tendera M, et al. Hemoglobin and change in hemoglobin status predict mortality, cardiovascular events, and bleeding in stable coronary artery disease. Am J Med 2017;130:720-30. |
38. | Park JY, Choi BG, Rha SW, Kang TS. Five-year outcomes in patients with anemia on admission undergoing a coronary intervention for acute myocardial infarction in Koreans: Propensity score matching analysis. Coron Artery Dis 2018;29:647-51. |
39. | Liu CW, Liao PC, Chen KC, Chiu YW, Liu YH, Ke SR, et al. Relationship of serum uric acid and Killip class on mortality after acute ST-segment elevation myocardial infarction and primary percutaneous coronary intervention. Int J Cardiol 2017;226:26-33. |
40. | Mandurino-Mirizzi A, Crimi G, Raineri C, Pica S, Ruffinazzi M, Gianni U, et al. Elevated serum uric acid affects myocardial reperfusion and infarct size in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. J Cardiovasc Med (Hagerstown) 2018;19:240-6. |
41. | Gao Y, Guo L, Guan Q. Analysis of the relationship between hyperglycemia and prognosis in elderly patients with high-risk acute myocardial infarction. PLA Med J 2013;38:496-500. |
42. | Monnier L, Mas E, Ginet C, Michel F, Villon L, Cristol JP, et al. Activation of oxidative stress by acute glucose fluctuations compared with sustained chronic hyperglycemia in patients with type 2 diabetes. JAMA 2006;295:1681-7. |
43. | Knudsen EC, Seljeflot I, Abdelnoor M, Eritsland J, Mangschau A, Arnesen H, et al. Abnormal glucose regulation in patients with acute ST – Elevation myocardial infarction-a cohort study on 224 patients. Cardiovasc Diabetol 2009;8:6. |
44. | Tajstra M, Gasior M, Gierlotka M, Pres D, Hawranek M, Trzeciak P, et al. Comparison of five-year outcomes of patients with and without chronic total occlusion of noninfarct coronary artery after primary coronary intervention for ST-segment elevation acute myocardial infarction. Am J Cardiol 2012;109:208-13. |
45. | Deng J, Wang X, Shi Y, Zhao X, Han Y. Prognostic value of the age, creatinine, and ejection fraction score for non-infarct-related chronic total occlusion revascularization after primary percutaneous intervention in acute ST-elevation myocardial infarction patients: A retrospective study. J Interv Cardiol 2018;31:33-40. |
46. | Buller CE, Fu Y, Mahaffey KW, Todaro TG, Adams P, Westerhout CM, et al. ST-segment recovery and outcome after primary percutaneous coronary intervention for ST-elevation myocardial infarction: Insights from the Assessment of Pexelizumab in Acute Myocardial Infarction (APEX-AMI) trial. Circulation 2008;118:1335-46. |
47. | Kim SH, Behnes M, Mashayekhi K, Bufe A, Meyer-Gessner M, El-Battrawy I, et al. Prognostic impact of percutaneous coronary intervention of chronic total occlusion in acute and periprocedural myocardial infarction. J Clin Med 2021;10:258. |
48. | O'Connor SA, Garot P, Sanguineti F, Hoebers LP, Unterseeh T, Benamer H, et al. Meta-analysis of the impact on mortality of noninfarct-related artery coronary chronic total occlusion in patients presenting with ST-segment elevation myocardial infarction. Am J Cardiol 2015;116:8-14. |
49. | Eitel I, Franke A, Schuler G, Thiele H. ST-segment resolution and prognosis after facilitated versus primary percutaneous coronary intervention in acute myocardial infarction: A meta-analysis. Clin Res Cardiol 2010;99:1-11. |
50. | Ndrepepa G, Alger P, Kufner S, Mehilli J, Schömig A, Kastrati A. ST-segment resolution after primary percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction. Cardiol J 2012;19:61-9. |
51. | Kumar S, Hsieh C, Sivagangabalan G, Chan H, Ryding AD, Narayan A, et al. Prognostic impact of Q waves on presentation and ST resolution in patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention. Am J Cardiol 2009;104:780-5. |
52. | Zhang Q, Zhang RY, Zhu TQ, Hu J, Yang ZK, Ding FH, et al. Impact of angina prior to acute ST-elevation myocardial infarction on short-term outcomes after primary percutaneous coronary intervention: Results from the Shanghai Registry of Acute Coronary Syndrome (SRACE). Chin Med J (Engl) 2012;125:977-82. |
53. | Murry CE, Jennings RB, Reimer KA. Preconditioning with ischemia: A delay of lethal cell injury in ischemic myocardium. Circulation 1986;74:1124-36. |
54. | Zahler D, Lee-Rozenfeld K, Ravid D, Rozenbaum Z, Banai S, Keren G, et al. Relation of lowering door-to-balloon time and mortality in ST segment elevation myocardial infarction patients undergoing percutaneous coronary intervention. Clin Res Cardiol 2019;108:1053-8. |
55. | Park J, Choi KH, Lee JM, Kim HK, Hwang D, Rhee TM, et al. Prognostic Implications of door-to-balloon time and onset-to-door time on mortality in patients with ST segment-elevation myocardial infarction treated with primary percutaneous coronary intervention. J Am Heart Assoc 2019;8:e012188. |
56. | Chandrasekhar J, Marley P, Allada C, McGill D, O'Connor S, Rahman M, et al. Symptom-to-balloon time is a strong predictor of adverse events following primary percutaneous coronary intervention: Results from the Australian Capital territory PCI registry. Heart Lung Circ 2017;26:41-8. |
57. | Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, et al. 2017 ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The task force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J 2018;39:119-77. |
58. | Bradley EH, Nallamothu BK, Herrin J, Ting HH, Stern AF, Nembhard IM, et al. National efforts to improve door-to-balloon time results from the door-to-balloon alliance. J Am Coll Cardiol 2009;54:2423-9. |
59. | Trzeciak P, Gierlotka M, Gąsior M, Lekston A, Wilczek K, Słonka G, et al. Mortality of patients with ST-segment elevation myocardial infarction and cardiogenic shock treated by PCI is correlated to the infarct-related artery – Results from the PL-ACS registry. Int J Cardiol 2013;166:193-7. |
60. | Cervellin G, Rastelli G. The clinics of acute coronary syndrome. Ann Transl Med 2016;4:191. |
61. | Vis M M, Sjauw K D, Schaaf R, et al. In patients with ST-segment elevation myocardial infarction with cardiogenic shock treated with percutaneous coronary intervention, admission glucose level is a strong independent predictor for 1-year mortality in patients without a prior diagnosis of diabetes. ACC Cardiosource Review J 2007;154:1184-90. |
62. | Zhang Q, Zhang R-y, Shen J, et al. Impact of admission creatinine level on clinical outcomes of patients with acute ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention with drug-eluting stent implantation. Chinese Medi J 2008;121:2379-83. |
63. | Nienhuis MB, Ottervanger JP, Dambrink J-HE, et al. Comparative predictive value of infarct location, peak CK, and ejection fraction after primary PCI for ST elevation myocardial infarction. Coronary Artery Disease 2009;20:9-14. |
64. | Zimmermann S, Ruthrof S, Nowak K, et al. Short-term prognosis of contemporary interventional therapy of ST-elevation myocardial infarction: does gender matter? Clinical Research in Cardiology 2009;98:709-15. |
65. | Zimmermann S, Ruthrof S, Nowak K, et al. Outcomes of Contemporary Interventional Therapy of ST Elevation Infarction in Patients Older than 75 Years. Clinical Cardiology 2009;32:87-93. |
66. | Bufe A, Wolfertz J, Dinh W, et al. Gender-Based Differences in Long-Term Outcome After ST-Elevation Myocardial Infarction in Patients Treated with Percutaneous Coronary Intervention. Journal of Womens Health 2010;19:471-5. |
67. | Lekston A, Slonka G, Gasior M, et al. Comparison of early and long-term results of percutaneous coronary interventions in patients with ST elevation myocardial infarction, complicated or not by cardiogenic shock. Coronary Artery Disease 2010;21:13-9. |
68. | Claessen BEPM, Peter Damman MMV, Karel T Koch, Jan Baan Jr, Martijn Meuwissen,, Rene´ J van der Schaaf RJdW, et al. Primary percutaneous coronary intervention for ST elevation myocardial infarction in octogenarians:trends and outcomes. Acute coronary syndromes 2010;96:843e847. |
69. | Pres D, Gasior M, Strojek K, et al. Blood glucose level on admission determines in-hospital and long-term mortality in patients with ST-segment elevation myocardial infarction complicated by cardiogenic shock treated with percutaneous coronary intervention. Kardiologia Polska 2010;68:743-51. |
70. | Hannan EL, Zhong Y, Jacobs AK, et al. Effect of onset-to-door time and door-to-balloon time on mortality in patients undergoing percutaneous coronary interventions for st-segment elevation myocardial infarction. The American journal of cardiology 2010;106:143-7. |
71. | Parodi G, Bellandi B, Valenti R, et al. Heart rate as an independent prognostic risk factor in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention. Atherosclerosis 2010;211:255-9. |
72. | van der Zwaan HB, Stoel MG, Roos-Hesselink JW, Veen G, Boersma E, von Birgelen C. Early versus late ST-segment resolution and clinical outcomes after percutaneous coronary intervention for acute myocardial infarction. Netherlands Heart Journal 2010;18:416-22. |
73. | Hoebers LPC, Kikkert W, Damman P, et al. Predictive value of plasma glucose level at admission for short and long term mortality in patients with ST elevation myocardial infarction treated with primary percutaneous coronary intervention. European Heart Journal 2010;31:896-7. |
74. | Kang WY, Jeong MH, Ahn YK, et al. Obesity paradox in Korean patients undergoing primary percutaneous coronary intervention in ST-segment elevation myocardial infarction. Journal of Cardiology 2010;55:84-91. |
75. | Zheng X, Li J-j, Yuan J-q, et al. Coronary intervention in patients >= 75 years old with ST-elevation myocardial infarction: in-hospital and 6-month clinical outcomes. Chinese Medical Journal 2010;123:2171-5. |
76. | Newell MC, Henry JT, Henry TD, et al. Impact of age on treatment and outcomes in ST-elevation myocardial infarction. American Heart Journal 2011;161:664-72. |
77. | Hudson MP, Armstrong PW, O'Neil WW, et al. Mortality implications of primary percutaneous coronary intervention treatment delays: insights from the Assessment of Pexelizumab in Acute Myocardial Infarction trial. Circulation Cardiovascular quality and outcomes 2011;4:183-92. |
78. | Birkemeyer R, Rillig A, Treusch F, et al. Outcome and treatment quality of transfer primary percutaneous intervention in older patients with acute ST-elevation myocardial infarction (STEMI). Archives of gerontology and geriatrics 2011;53:e259-e262. |
79. | Gharacholou SM, Lopes RD, Alexander KP, et al. Age and Outcomes in ST-Segment Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention Findings From the APEX-AMI Trial. Archives of Internal Medicine 2011;171:559-67. |
80. | Lawesson SS, Todt T, Alfredsson J, Janzon M, Stenestrand U, Swahn E. Gender difference in prevalence and prognostic impact of renal insufficiency in patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention. Heart 2011;97:308-14. |
81. | Siudak Z, Rakowski T, Dziewierz A, et al. Primary percutaneous coronary intervention during on- vs off-hours in patients with ST-elevation myocardial infarction. Results from EUROTRANSFER Registry. Kardiologia Polska 2011;69:1017-22. |
82. | Planer D, Witzenbichler B, Guagliumi G, et al. Impact of Hyperglycemia in Patients with ST-Segment Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention: The HORIZONS-AMI Trial. Journal of the American College of Cardiology 2012;58:B27-B27. |
83. | Kaul P, Fu Y, Westerhout CM, Granger CB, Armstrong PW. Relative prognostic value of baseline Q wave and time from symptom onset among men and women with ST-elevation myocardial infarction undergoing percutaneous coronary intervention. American journal of cardiology 2012;110:1555-60. |
84. | Siudak Z, Birkemeyer R, Dziewierz A, et al. Out-of-hospital cardiac arrest in patients treated with primary PCI for STEMI. Long-term follow up data from EUROTRANSFER registry. Resuscitation 2012;83:303-6. |
85. | Lazzeri C, Valente S, Chiostri M, et al. Impact of Age on the Prognostic Value of Body Mass Index in ST-Elevation Myocardial Infarction. Nutrition Metabolism and Cardiovascular Diseases 2013;23:205-11. |
86. | Christiansen EC, Wickstrom KK, Henry TD, et al. Comparison of functional recovery following percutaneous coronary intervention for ST elevation myocardial infarction in three age groups (<70, 70 to 79, and ≥80 years). The American journal of cardiology 2013;112:330-5. |
87. | Han Y-C, Yang T-H, Kim D-I, et al. Neutrophil to Lymphocyte Ratio Predicts Long-Term Clinical Outcomes in Patients with ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. Korean Circulation Journal 2013;43:93-9. |
88. | Wijnbergen I, Tijssen J, van 't Veer M, Michels R, Pijls NH. Gender differences in long-term outcome after primary percutaneous intervention for ST-segment elevation myocardial infarction. Catheterization and cardiovascular interventions 2013;82:379-84. |
89. | Kaya MG, Akpek M, Lam YY, et al. Prognostic value of neutrophil/lymphocyte ratio in patients with ST-elevated myocardial infarction undergoing primary coronary intervention: A prospective, multicenter study. International Journal of Cardiology 2013;168:1154-9. |
90. | Ki-Woon Kang, Seong-Kyu Lee, Hyeon Soo Yoon et al. Influence of the Obesity on Clinical Outcomes in the Young Korean Patients with Acute ST-Elevation Myocardial Infarction. The Korean Journal of Obesity 2013;22:215-21. |
91. | Antonsen L, Jensen LO, Terkelsen CJ, et al. Outcomes after primary percutaneous coronary intervention in octogenarians and nonagenarians with ST-segment elevation myocardial infarction: From the Western Denmark heart registry. Catheterization and Cardiovascular Interventions 2013;81:912-9. |
92. | Farkouh ME, Reiffel J, Dressler O, et al. Relationship between ST-segment recovery and clinical outcomes after primary percutaneous coronary intervention: the HORIZONS-AMI ECG substudy report. Circulation Cardiovascular interventions 2013;6:216-23. |
93. | Cubeddu RJ, Palacios IF, Blankenship JC, et al. Outcome of Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. During On- Versus Off-hours (A Harmonizing Outcomes With RevasculariZatiON and Stents in Acute Myocardial Infarction HORIZONS-AMI Trial Substudy). American Journal of Cardiology 2013;111:946-54. |
94. | Tsai T-H, Yeh K-H, Sun C-K, et al. Estimated Glomerular Filtration Rate as a Useful Predictor of Mortality in Patients With Acute Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. American Journal of the Medical Sciences 2013;345:104-11. |
95. | Allahwala UK, Murphy JC, Nelson GIC, Bhindi R. Absence of a 'smoker's paradox' in field triaged ST-elevation myocardial infarction patients undergoing percutaneous coronary intervention. Cardiovascular revascularization medicine : including molecular interventions 2013;14:213-7. |
96. | Zimmermann S, Flachskampf FA, Alff A, et al. Out-of-hospital cardiac arrest and percutaneous coronary intervention for ST-elevation myocardial infarction: Long-term survival and neurological outcome. International Journal of Cardiology 2013;166:236-41. |
97. | Tomaszuk-Kazberuk A, Bolinska S, Mlodawska E, Lopatowska P, Sobkowicz B, Musial W. Does admission anaemia still predict mortality six years after myocardial infarction? Kardiologia Polska. 2014;72:488-93. |
98. | Pusuroglu H, Akgul O, Cakmak HA, et al. Long-term prognostic value of admission haemoglobin A1c (HbA1c) levels in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Postepy w kardiologii interwencyjnej = Advances in interventional cardiology 2014;10:166-74. |
99. | Zhang J-w, He L-j, Cao S-j, Yang Q, Yang S-w, Zhou Y-j. Effect of glycemic variability on short term prognosis in acute myocardial infarction subjects undergoing primary percutaneous coronary interventions. Diabetology & Metabolic Syndrome. 2014;6. |
100. | Rathod KS, Jones DA, Rathod VS, et al. Prognostic impact of anaemia on patients with ST-elevation myocardial infarction treated by primary PCI. Coronary artery disease 2014;25:52-9. |
101. | David RB, Almeida ED, Cruz LV, et al. Diabetes mellitus and glucose as predictors of mortality in primary coronary percutaneous intervention. Arquivos brasileiros de cardiologia 2014;103:323-30. |
102. | Taniguchi T, Shiomi H, Toyota T, et al. Effect of Preinfarction Angina Pectoris on Long-term Survival in Patients With ST-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention. American Journal of Cardiology 2014;114:1179-86. |
103. | Ho Y-C, Tsai T-H, Sung P-H, et al. Minimizing door-to-balloon time is not the most critical factor in improving clinical outcome of ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention. Critical care medicine. 2014;42(8):1788-1796. |
104. | Claessen BEPM, Kikkert WJ, Hoebers LP, et al. Long-term ischaemic and bleeding outcomes after primary percutaneous coronary intervention for ST-elevation myocardial infarction in the elderly. Netherlands Heart Journal 2015;23:477-82. |
105. | Wang CH, Zhang SY, Fang Q, et al. Renal dysfunction and hsCRP predict long-term outcomes of percutaneous coronary intervention in acute myocardial infarction. American journal of the medical sciences 2015;349:413-20. |
106. | Laufer-Perl M, Shacham Y, Letourneau-Shesaf S, et al. Gender-related mortality and in-hospital complications following ST-segment elevation myocardial infarction: data from a primary percutaneous coronary intervention cohort. Clinical cardiology 2015;38:145-9. |
107. | Iqbal MB, Khamis R, Ilsley C, et al. Time-Trend Analyses of Bleeding and Mortality After Primary Percutaneous Coronary Intervention During Out of Working Hours Versus In-Working Hours An Observational Study of 11 466 Patients. Circulation-Cardiovascular Interventions 2015;8(6). |
108. | Barthelemy O, Degrell P, Berman E, et al. Sex-related differences after contemporary primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. Archives of Cardiovascular Diseases 2015;108:428-36. |
109. | Pan W, Zhao D, Zhang C, et al. Application of neutrophil/lymphocyte ratio in predicting coronary blood flow and mortality in patients with ST-elevation myocardial infarction undergoing percutaneous coronary intervention. Journal of Cardiology 2015;66:9-14. |
110. | Liu C-W, Liao P-C, Chen K-C, et al. Baseline Hemoglobin Levels Associated with One-Year Mortality in ST-Segment Elevation Myocardial Infarction Patients. Acta Cardiologica Sinica 2016;32:656-66. |
111. | Cicek G, Korkmaz A. Two-year prognosis of admission hemoglobin A1c following a primary percutaneous coronary intervention. Coronary Artery Disease 2016;27:673-81. |
112. | Geng J, Ye X, Liu C, et al. Outcomes of off- and on-hours admission in ST-segment elevation myocardial infarction patients undergoing primary percutaneous coronary intervention A retrospective observational cohort study. Medicine 2016;95(27). |
113. | Rathod KS, Jones DA, Gallagher S, et al. Atypical risk factor profile and excellent long-term outcomes of young patients treated with primary percutaneous coronary intervention for ST-elevation myocardial infarction. European heart journal Acute cardiovascular care 2016;5:23-32. |
114. | Ma W-f, Liang Y, Zhu J, et al. Comparison of 4 Admission Blood Pressure Indexes for Predicting 30-Day Mortality in Patients With ST-Segment Elevation Myocardial Infarction. American Journal of Hypertension 2016;29:332-9. |
115. | Hemradj VV, Ottervanger JP, van 't Hof AW, et al. Cardiogenic Shock Predicts Long-term Mortality in Hospital Survivors of STEMI Treated with Primary Percutaneous Coronary Intervention. Clinical cardiology 2016;39:665-9. |
116. | Topaz G, Finkelstein A, Flint N, et al. Comparison of 30-Day and Long-Term Outcomes and Hospital Complications Among Patients Aged < 75 Versus >= 75 Years With ST-Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention. American Journal of Cardiology 2017;119:1897-901. |
117. | Kanic V, Suran D, Vollrath M, Tapajner A, Kompara G. Influence of minor deterioration of renal function after PCI on outcome in patients with ST-elevation myocardial infarction. Journal of Interventional Cardiology 2017;30:473-9. |
118. | Ertelt K, Brener SJ, Mehran R, Ben-Yehuda O, McAndrew T, Stone GW. Comparison of Outcomes and Prognosis of Patients With Versus Without Newly Diagnosed Diabetes Mellitus After Primary Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction (the HORIZONS-AMI Study). American journal of cardiology (no pagination), 2017. 2017;Date of Publication: February 08. |
119. | Kosmidou I, Redfors B, Crowley A, et al. Prognostic implications of Q waves at presentation in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: an analysis of the HORIZONS-AMI study. Clinical cardiology 2017;40:982-7. |
120. | Yudi MB, Hamilton G, Farouque O, et al. Trends and Impact of Door-to-Balloon Time on Clinical Outcomes in Patients Aged <75, 75 to 84, and >/=85 Years With ST-Elevation Myocardial Infarction. The American journal of cardiology 2017;120:1245-53. |
121. | Wu PJ, Wang HT, Sung PH, et al. No correlation between body mass index and 30-day prognostic outcome in Asians with acute ST-elevation myocardial infarction undergoing primary coronary intervention. Biomedical journal 2017;40:169-77. |
122. | Zuin M, Rigatelli G, Picariello C, et al. Correlation and prognostic role of neutrophil to lymphocyte ratio and SYNTAX score in patients with acute myocardial infarction treated with percutaneous coronary intervention: A six-year experience. Cardiovascular revascularization medicine : including molecular interventions 2017;18:565-71. |
123. | Rumiz E, Berenguer A, Vicente Vilar J, et al. Long-term outcomes and predictors of morbi-mortality according to age in stemi patients with multivessel disease: Impact of an incomplete revascularization. Catheterization and Cardiovascular Interventions 2018;92:E512-17. |
124. | Fu WX, Zhou TN, Wang XZ, Zhang L, Jing QM, Han YL. Sex-Related Differences in Short- and Long-Term Outcome among Young and Middle-Aged Patients for ST-Segment Elevation Myocardial Infarction Underwent Percutaneous Coronary Intervention. Chinese medical journal 2018;131:1420-9. |
125. | Ghetti G, Bacchi Reggiani ML, Rosetti C, et al. Prodromal angina and risk of 2-year cardiac mortality in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous intervention. Medicine 2018;97:e12332. |
126. | Spitaleri G, Brugaletta S, Scalone G, et al. Role of ST-Segment Resolution in Patients With ST-Segment Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention (from the 5-Year Outcomes of the EXAMINATION [Evaluation of the Xience-V Stent in Acute Myocardial Infarction] Trial). The American journal of cardiology 2018;121:1039-45. |
127. | Kanic V, Kompara G, Vollrath M, Suran D, Kanic Z. Sex-Related Anemia Contributes to Disparities in Outcome of Patients Younger Than 60 Years with ST-Elevation Myocardial Infarction. Journal of Womens Health 2018;27:755-60. |
128. | Cenko E, van der Schaar M, Yoon J, et al. Sex-Specific Treatment Effects After Primary Percutaneous Intervention: A Study on Coronary Blood Flow and Delay to Hospital Presentation. Journal of the American Heart Association 2019;8(4). |
129. | Park J, Choi KH, Lee JM, et al. Prognostic Implications of Door-to-Balloon Time and Onset-to-Door Time on Mortality in Patients With ST-Segment-Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention. Journal of the American Heart Association 2019;8(9). |
130. | Krishnamurthy A, Keeble C, Burton-Wood N, et al. Clinical outcomes following primary percutaneous coronary intervention for ST-elevation myocardial infarction according to sex and race. European heart journal Acute cardiovascular care 2019;8:264-72. |
131. | Steele L, Palmer J, Lloyd A, Fotheringham J, Iqbal J, Grech ED. The impact of smoking on mortality after acute ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention: a retrospective cohort outcome study at 3years. Journal of Thrombosis and Thrombolysis 2019;47:520-6. |
132. | Murphy AC, Yudi MB, Farouque O, et al. Impact of Gender and Door-to-Balloon Times on Long-Term Mortality in Patients Presenting With ST-Elevation Myocardial Infarction. The American journal of cardiology 2019;124:833-41. |
133. | Stehli J, Martin C, Brennan A, Dinh DT, Lefkovits J, Zaman S. Sex Differences Persist in Time to Presentation, Revascularization, and Mortality in Myocardial Infarction Treated With Percutaneous Coronary Intervention. Journal of the American Heart Association 2019;8:e012161. |
134. | Luke P. Dawson a DDb, Stephen Duffy b,c,d, Angela Brennan b, David Clark e,Christopher M. Reid b, David Blusztein a, Dion Stub b,c,d, Nick Andrianopoulos b,Melanie Freeman f, Ernesto Oqueli g,h, Andrew E. Ajani a,b,*, . Short- and long-term outcomes of out-of-hospital cardiac arrest following ST-elevation myocardial infarction managed with percutaneous coronary intervention. RESUSCITATION 2020;150:121-9. |
135. | |
[Figure 1], [Figure 2], [Figure 3], [Figure 4]
[Table 1], [Table 2], [Table 3]
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