Table 1. Baseline clinical characteristics of the patients.
|
All
|
STEMI
|
NSTEMI
|
p-value
|
|
N=1,175
|
N=715
|
N=460
|
Characteristics
|
|
|
|
|
Age, year^
|
67.65±13.86
|
65.68±14.05
|
70.70±12.99
|
<.001
|
Gender#
|
|
|
|
<.001
|
Male
|
804 (68.43)
|
524 (73.29)
|
280 (60.87)
|
|
Female
|
371 (31.57)
|
191 (26.71)
|
180 (39.13)
|
|
Treatment
|
|
|
|
|
IABP use#
|
274 (23.32)
|
175 (24.48)
|
99 (21.52)
|
0.243
|
ECMO use#
|
68 (5.79)
|
49 (6.85)
|
19 (4.13)
|
0.051
|
ECMO days^
|
2.50±0.95
|
2.35±0.93
|
2.89±0.94
|
0.033
|
PCI#
|
481 (40.94)
|
296 (41.40)
|
185 (40.22)
|
0.688
|
CABG#
|
99 (8.43)
|
56 (7.83)
|
43 (9.35)
|
0.361
|
Intubation#
|
182 (15.49)
|
100 (13.99)
|
82 (17.83)
|
0.076
|
Inotropes treatment#
|
|
|
|
|
Dopamine
|
716 (60.94)
|
502 (70.21)
|
214 (46.52)
|
<.001
|
Dobutamine
|
162 (13.79)
|
107 (14.97)
|
55 (11.96)
|
0.144
|
Norepinephrine
|
474 (40.34)
|
238 (33.29)
|
236 (51.30)
|
<.001
|
Epinephrine
|
288 (24.51)
|
168 (23.50)
|
120 (26.09)
|
0.314
|
Comorbidity#
|
|
|
|
|
OHCA
|
81 (6.89)
|
61 (8.53)
|
20 (4.35)
|
0.006
|
Diabetes
|
348 (29.62)
|
155 (21.68)
|
193 (41.96)
|
<.001
|
Insulin-requiring
|
289 (24.6)
|
109 (15.24)
|
180 (39.13)
|
<.001
|
Hypertension
|
484 (41.19)
|
240 (33.57)
|
244 (53.04)
|
<.001
|
Hyperlipidemia
|
347 (29.53)
|
182 (25.45)
|
165 (35.87)
|
<0.001
|
Atrial fibrillation
|
52 (4.43)
|
24 (3.36)
|
28 (6.09)
|
0.026
|
COPD
|
177 (15.06)
|
75 (10.49)
|
102 (22.17)
|
<.001
|
CKD
|
230 (19.57)
|
75 (10.49)
|
155 (33.7)
|
<.001
|
ESRD on dialysis
|
134 (11.4)
|
37 (5.17)
|
97 (21.09)
|
<.001
|
PAOD
|
80 (6.81)
|
28 (3.92)
|
52 (11.3)
|
<.001
|
Gout
|
140 (11.91)
|
61 (8.53)
|
79 (17.17)
|
<.001
|
Malignancy
|
104 (8.85)
|
53 (7.41)
|
51 (11.09)
|
0.030
|
Previous HF
|
212 (18.04)
|
90 (12.59)
|
122 (26.52)
|
<.001
|
Previous MI
|
181 (15.4)
|
85 (11.89)
|
96 (20.87)
|
<.001
|
Previous CVA
|
219 (18.64)
|
100 (13.99)
|
119 (25.87)
|
<.001
|
Previous PCI
|
146 (12.43)
|
63 (8.81)
|
83 (18.04)
|
<.001
|
Previous CABG
|
22 (1.87)
|
10 (1.4)
|
12 (2.61)
|
0.135
|
Lab& median (IQR)
|
|
|
|
|
Hb
|
12.45(4)
|
13.2(3.7)
|
11.2(3.6)
|
<.001
|
Cr
|
1.47(1.24)
|
1.36(0.92)
|
1.725(2.46)
|
<.001
|
Na
|
138(5)
|
138(5)
|
138(6)
|
0.007
|
K
|
4(0.9)
|
3.9(0.8)
|
4(1)
|
0.056
|
ALT
|
41(63)
|
51(88)
|
31(40)
|
<.001
|
CRP
|
44.36(110.2)
|
44.4(109.2)
|
44.36(112.4)
|
0.705
|
Index admission days^
|
12.73±11.04
|
12.19±10.79
|
13.56±11.39
|
0.038
|
^ t test; # χ2 test; & Kruskal-Wallis test; ALT: alanine aminotransferase; CABG: coronary artery bypass grafting; CKD: chronic kidney disease; COPD: chronic obstructive pulmonary disease; Cr: serum creatinine; CRP: C-reactive protein; CVA: cerebral vascular accident; ECMO: extracorporeal membrane oxygenation; ESRD: end-stage renal disease; Hb: serum hemoglobin; HF: heart failure; IABP: intra-aortic balloon pump; K: serum potassium; MI: myocardial infarction; Na: serum sodium; OHCA: Out-of-hospital cardiac arrest; PAOD: peripheral artery occlusive disease; PCI: percutaneous coronary intervention
Table 2. Outcomes for 30-day or index hospitalization mortality.
|
Number of event (%)
|
OR (95% CI)*
|
P
|
Outcome
|
STEMI
N=715
|
NSTEMI
N=460
|
Primary Outcomes
|
|
|
|
|
30 days or index hospitalization mortality
|
106 (14.83)
|
98 (21.30)
|
1.56 (1.15-2.11)
|
0.004
|
30 days mortality
|
102 (14.27)
|
88 (19.13)
|
1.42 (1.04-1.94)
|
0.028
|
Mortality at index hospitalization
|
106 (14.83)
|
97 (21.09)
|
1.54 (1.13-2.08)
|
0.006
|
Secondary Outcomes
|
|
|
|
|
New onset of dialysis
|
22 (3.08)
|
37 (8.04)
|
0.36 (0.21-0.63)
|
<.001
|
New onset of CVA
|
|
|
|
|
Ischemic stroke
|
9 (1.26)
|
8 (1.74)
|
0.72 (0.28-1.89)
|
0.503
|
Hemorrhagic stroke
|
5 (0.70)
|
1 (0.22)
|
3.22 (0.38-25.0)
|
0.285
|
Major bleeding
|
19 (2.66)
|
1 (0.22)
|
12.5 (1.67-100.0)
|
0.014
|
Gastrointestinal bleeding
|
24 (3.36)
|
1 (0.22)
|
16.7 (2.13-100.0)
|
0.007
|
Pneumonia
|
133 (18.60)
|
109 (23.70)
|
0.74 (0.55-0.98)
|
0.035
|
Sepsis
|
139 (19.44)
|
148 (32.17)
|
0.51 (0.39-0.67)
|
<.001
|
*Ref. = SETMI; CVA: cerebral vascular accident
Table 3. Outcomes for 1-year follow-up cases.
|
Number of event (%)
|
HR (95% CI)*
|
P
|
Outcome
|
STEMI
N=609
|
NSTEMI
N=363
|
CV outcome
|
|
|
|
|
Myocardial infarction
|
|
|
|
|
STEMI
|
10 (1.64)
|
4 (1.10)
|
0.67 (0.21-2.13)
|
0.497
|
NSTEMI
|
10 (1.64)
|
16 (4.41)
|
2.72 (1.24-6.00)
|
0.013
|
Revascularization
|
|
|
|
|
PCI
|
58 (9.52)
|
20 (5.51)
|
0.56 (0.34-0.94)
|
0.027
|
CABG
|
4 (0.66)
|
4 (1.10)
|
1.68 (0.42-6.73)
|
0.461
|
Heart failure admission
|
55 (9.03)
|
47 (12.95)
|
1.46 (0.99-2.15)
|
0.057
|
Death from any cause
|
16 (2.63)
|
15 (4.13)
|
1.58 (0.78-3.20)
|
0.202
|
Neurologic outcome
|
|
|
|
|
Ischemic stroke
|
3 (0.49)
|
1 (0.28)
|
0.56 (0.06-5.36)
|
0.613
|
Hemorrhagic stroke
|
1 (0.16)
|
1 (0.28)
|
1.68 (0.11-26.8)
|
0.715
|
Unspecified stroke
|
9 (1.48)
|
7 (1.93)
|
1.31 (0.49-3.52)
|
0.592
|
Safety outcome
|
|
|
|
|
Major bleeding
|
3 (0.49)
|
1 (0.28)
|
0.56 (0.06-5.38)
|
0.615
|
GI bleeding
|
4 (0.66)
|
1 (0.28)
|
0.42 (0.05-3.75)
|
0.437
|
*Ref. = SETMI; CABG: coronary artery bypass grafting; CV: cardiovascular; GI: gastrointestinal; PCI: percutaneous coronary intervention
Table 4a. Subgroup analysis of predictors of 30-day or in-hospital mortality in ST-elevation myocardial infarction (STEMI).
|
Univariate analysis
|
Multivariate analysis
|
Variables
|
HR
|
95% CI
|
p-value
|
HR
|
95% CI
|
p-value
|
Age, > 65 yrs
|
1.91
|
(1.27-2.86)
|
0.002
|
1.67
|
(1.10-2.56)
|
0.017
|
Male
|
0.53
|
(0.36-0.79)
|
0.002
|
0.64
|
(0.43-0.96)
|
0.031
|
Treatment
|
|
|
|
|
|
|
IABP use
|
1.1
|
(0.71-1.69)
|
0.670
|
-
|
-
|
-
|
ECMO use
|
2.58
|
(1.51-4.40)
|
0.001
|
3.11
|
(1.79-5.39)
|
<.001
|
ECMO days
|
0.61
|
(0.34-1.08)
|
0.089
|
-
|
-
|
-
|
Intubation
|
2.23
|
(1.45-3.44)
|
0.0003
|
1.99
|
(1.28-3.10)
|
0.002
|
Revascularization
|
0.35
|
(0.23-0.54)
|
<.0001
|
0.45
|
(0.18-1.12)
|
0.085
|
PCI
|
0.35
|
(0.22-0.56)
|
<.0001
|
0.76
|
(0.29-2.03)
|
0.589
|
CABG
|
0.75
|
(0.35-1.63)
|
0.472
|
-
|
-
|
-
|
Comorbidity
|
|
|
|
|
|
|
Diabetes mellitus
|
0.93
|
(0.58-1.49)
|
0.763
|
-
|
-
|
-
|
Insulin-requiring
|
1.06
|
(0.63-1.78)
|
0.834
|
-
|
-
|
-
|
Hypertension
|
1.38
|
(0.94-2.03)
|
0.104
|
-
|
-
|
-
|
Hyperlipidemia
|
0.94
|
(0.60-1.46)
|
0.775
|
-
|
-
|
-
|
Atrial fibrillation
|
2.06
|
(0.96-4.43)
|
0.065
|
-
|
-
|
-
|
COPD
|
1.32
|
(0.75-2.32)
|
0.333
|
-
|
-
|
-
|
CKD
|
1.2
|
(0.67-2.15)
|
0.537
|
-
|
-
|
-
|
PAOD
|
1.58
|
(0.69-3.61)
|
0.275
|
-
|
-
|
-
|
Gout
|
0.86
|
(0.42-1.77)
|
0.682
|
-
|
-
|
-
|
Malignancy
|
1.44
|
(0.77-2.70)
|
0.249
|
-
|
-
|
-
|
Previous CABG
|
0.7
|
(0.10-4.98)
|
0.719
|
-
|
-
|
-
|
Dialysis
|
1.76
|
(0.89-3.49)
|
0.105
|
-
|
-
|
-
|
Adjusted variable: Age group, gender, ECMO use, Intubation, Revascularization, PCI; CABG: coronary artery bypass grafting; CKD: chronic kidney disease; COPD: chronic obstructive pulmonary disease; ECMO: extracorporeal membrane oxygenation; IABP: intra-aortic balloon pump; PAOD: peripheral artery occlusive disease; PCI: percutaneous coronary intervention
Table 4b. Subgroup analysis of predictors of 30-day or in-hospital mortality in non-ST-elevation myocardial infarction (NSTEMI).
|
Univariate analysis
|
Multivariate analysis
|
Variables
|
HR
|
95% CI
|
p-value
|
HR
|
95% CI
|
p-value
|
Age, > 65 yrs
|
2.99
|
(1.72-5.19)
|
<.0001
|
2.66
|
(1.52-4.67)
|
0.001
|
Male
|
0.68
|
(0.46-1.01)
|
0.057
|
-
|
-
|
-
|
Treatment
|
|
|
|
|
|
|
IABP use
|
1.08
|
(0.68-1.73)
|
0.745
|
-
|
-
|
-
|
ECMO use
|
1.23
|
(0.50-3.03)
|
0.648
|
-
|
-
|
-
|
ECMO days
|
0.72
|
(0.30-1.74)
|
0.467
|
-
|
-
|
-
|
Intubation
|
2.03
|
(1.31-3.14)
|
0.002
|
2.17
|
(1.39-3.37)
|
0.001
|
Revascularization
|
0.37
|
(0.24-0.57)
|
<.0001
|
0.73
|
(0.33-1.63)
|
0.445
|
PCI
|
0.37
|
(0.23-0.60)
|
<.0001
|
0.52
|
(0.22-1.23)
|
0.135
|
CABG
|
0.75
|
(0.36-1.56)
|
0.447
|
-
|
-
|
-
|
Comorbidity
|
|
|
|
|
|
|
Diabetes mellitus
|
1.47
|
(0.99-2.18)
|
0.058
|
-
|
-
|
-
|
Insulin-requiring
|
1.38
|
(0.93-2.06)
|
0.111
|
-
|
-
|
-
|
Hypertension
|
1.35
|
(0.91-2.03)
|
0.140
|
-
|
-
|
-
|
Hyperlipidemia
|
1.33
|
(0.89-1.99)
|
0.166
|
-
|
-
|
-
|
Atrial fibrillation
|
1.57
|
(0.76-3.23)
|
0.224
|
-
|
-
|
-
|
COPD
|
1.36
|
(0.87-2.14)
|
0.177
|
-
|
-
|
-
|
CKD
|
1.82
|
(1.22-2.71)
|
0.003
|
1.28
|
(0.83-1.98)
|
0.271
|
PAOD
|
1.49
|
(0.87-2.56)
|
0.146
|
-
|
-
|
-
|
Gout
|
1.79
|
(1.13-2.84)
|
0.013
|
1.43
|
(0.86-2.37)
|
0.171
|
Malignancy
|
1.72
|
(1.01-2.94)
|
0.047
|
1.11
|
(0.64-1.93)
|
0.709
|
Previous CABG
|
0.74
|
(0.18-2.99)
|
0.670
|
-
|
-
|
-
|
Dialysis
|
1.52
|
(0.98-2.37)
|
0.064
|
-
|
-
|
-
|
Adjusted variable: Age group, Intubation, Revascularization, PCI, CKD, Gout, Malignancy CABG: coronary artery bypass grafting; CKD: chronic kidney disease; COPD: chronic obstructive pulmonary disease; ECMO: extracorporeal membrane oxygenation; IABP: intra-aortic balloon pump; PAOD: peripheral artery occlusive disease; PCI: percutaneous coronary intervention