RISK FACTORS AND HOSPITAL MORTALITY IN STEMI: MULTICENTER STUDY AUTHORS: I. Santos Rodríguez 1, G. Perez Ojeda 2, N. Alonso Orcajo 3, S. Estrada Gómez.

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RISK FACTORS AND HOSPITAL MORTALITY IN STEMI: MULTICENTER STUDY AUTHORS: I. Santos Rodríguez 1, G. Perez Ojeda 2, N. Alonso Orcajo 3, S. Estrada Gómez 1, MJ. Ruíz Olgado 4, JM. Duran 2, P. Pabón Osuna 1, Ma. Cruz Banuelos 5, C. Hernández 4, F. De Castro 5. on behalf of the study investigators RIAMCYL" (1) University Hospital of Salamanca, Salamanca, Spain (2) Hospital General Yague, Burgos, Spain (3) Hospital de Leon, Leon, Spain,(4) Hospital Virgen Concha, Zamora, Spain (5) Emergencias Sanitarias, Castilla y León, Spain The RIAMCYl study was supported in part by research grants from Sacyl (Regional Health Management of Castilla y León) and FUCALEC (Cardiology Foundation of Castilla and León). INTRODUCTION: Age, male gender, hyperlipidemia (HL), diabetes (DB), hypertension (HT) and smoking (SMK) are known risk factors (RF) of coronary artery disease. However its influence on hospital mortality (HM) in STEMI has not been well established and several studies have reported increased HM in women and lower HM in SMK. CONCLUSIONS:Our study showed that the gender and SMK differences in mortality in pts with STEMI can be attributed to age. Age, DB, TIMI risk and revascularization are the real determinants of mortality in STEMI. CONCLUSIONS: Our study showed that the gender and SMK differences in mortality in pts with STEMI can be attributed to age. Age, DB, TIMI risk and revascularization are the real determinants of mortality in STEMI. OBJECTIVE: Analyze the influence of RF and invasive management on hospital mortality in the STEMI. METHODS: Prospective observational study of all pts of Castilla-León Spain region included in the multicenter registry of STEMI (RIAMCYL), 2009 and We applied a univariate and multiple logistic regression analysis to estimate the influence of RF and invasive management on HM and calculate the Hazard ratios after adjusting for age. RESULTS: 533 pts with STEMI included in the study. The mean age of the pts were 65 (±14 years), 17% women, 40% SMK, 18% DB, 39% HL and 49% HT. 318 pts (58%) were treated with primary angioplasty (PPCI), 161 (30%) with thrombolytic therapy (TT) and 60 pts (11%) did not receive reperfusion therapy (NRT). The mean (SD) time from symptom to TT or PPCI was 3.3 (3.5) and 3.3 (6) hours respectively. The global HM was 8.4% (44 pts). In relation to the pts who survived, the pts who died were older (79 vs 64, P 0.000) and had poorer TIMI risk (7.6 vs 3.1; P 0.000). The difference in HM according to RF and treatment is showed in the table 1, and the difference according to smoking and gender in table 2 and 3. Table 1 A/B Hospital mortality % Hazard ratio (95% CI) A vs B P-value Women / men15.6/ (1,2-3.2)0.007 SMK/not-SMK2.9/ ( )0.000 DB/not-DB17.4/ ( )0.001 HL/not-HL5.9/ ( )0.09 HT/not-HT11.4/ ( )0.02 NRT/PPCI/TT17.0/9.9/2.5Not applicable0.001 PPCI/not-PPCI9.9/ ( )0.12 ESC Congress 2011, Paris, France The authors have not relationships to disclose IDi FUCALEC Investigación Desarrollo Innovación Table 3 RF vs SMK Non smoker n 317 Smoker n 210 P-value Age72 (SD 11)56 (SD 11)< 0,001 DB73 (23%)20 (9,5%)< 0,001 HL132 (42%)76 (36%)0,2 HT199 (63%)60 (29%)< 0,001 TIMI score4,4 (SD 2,5)2,2 (SD 2)< 0,001 GRACE score162 (SD 35)134 (SD 33)< 0,001 NRT39 (12%)20 (9,5%)0,5 PPCI187 (59%)123 (59%)0,9 TT91 (29%)67 (32%)0,4 H mortality38 (12%)6 (3%)< 0,001 Table 2 RF vs Sex Male n 434 Women n 93 P-value Age64 (SD 13)73 (SD 13)< 0,001 SMK195 (45%)15 (16%)< 0,001 DB62 (14%)31(33%)< 0,001 HL166 (38%)42.45%)< 0,3 HT197 (45%)62 (67%)< 0,001 NRT39 (9%)21 (23%)< 0,001 PPCI260 (59%)52 (56%)0,5 TT141 (32%)20 (21,5%)<0,05 H mortality30 (7%)14 (16%)0,007 After logistic regression analysis neither sex, nor SMK and HT were associated with mortality. After adjusted for age the only RF related to mortality were age (odds ratio 1.2 (95% CI ; P 0.000) and DB (odds ratio 2 (95% CI 1-4; P 0.05).