Clinical characteristic and in-hospital mortality of avr st elevation myocardial infarction

Abstract

Background: ST segment elevation (STE) in aVR (STE-aVR) is a less recognized finding and its clinical course is more severe and has a fewer prevalence than other walls of myocardial infarction and gives anticipation of early prognosis in some published evidences. Aim: To study clinical characteristics and in-hospital mortality in STE-aVR among Mongolian patients with acute myocardial infarction. Materials and Methods: This cross sectional study is based on patient’s medical records which admitted to coronary care unit of Shastin central hospital, Mongolia in 2019. Results: Total 554 patients records with acute coronary syndrome and 76.4% (n=423) of them were male, 75.1% were STEMI and among those STE-aVR were n=71. Total hospital length in non STE-aVR and STE-aVR group was 4.3±2.9 vs 5.56±4.1, respectively (p<0.001). Respiratory rate (RR) and SpO2 at hospital admission between 2 groups was RR: 18.9±3.6 vs 18.1±1.7 (p<0.001); SpO2: 92.3±7.8% vs 94.6±4.4% (p<0.001). Killip IV class cardiogenic shock was more observed in STE-aVR group compared to control group (25.7% vs 9.4%, p<0.001). Early cardiac arrest was also more frequently observed in STE-aVR group (6% vs 1.7%, p<0.03). Prevalence of multiple vessel disease was higher in STEaVR group (61.5% vs 39.1% p<0.001). In-hospital mortality was significantly higher in STE-aVR group compared to non-STE-aVR group (21.1% vs 8.6%, p<0.001). Conclusion: According to our study results, STE-aVR acute coronary syndrome’s clinical course is more severe, frequency and prevalence of cardiogenic shock and multiple vessel disease is higher and has a higher in-hospital mortality compared to non-STE-aVR acute coronary syndrome.