PDF(Pubmed)
Abstract：
Background/Objectives: In-hospital myocardial infarctions (AMIs) are less often treated with invasive intervention, compared to out-of-hospital AMIs. We aimed to identify the determinants of invasive intervention in patients with in-hospital AMIs and assess its association with mortality, compared to conservative treatment. Methods: This was a cross-sectional study of in-hospital AMIs in The Regional Myocardial Infarction Registry of Saxony-Anhalt. Patients\' characteristics and outcomes were compared based on the treatment strategy (invasive intervention vs. conservative treatment). Logistic regression was performed to assess the determinants of invasive intervention (vs. conservative treatment) and its association with 30-day mortality. Results: Nearly 67% of the patients (259/386) received invasive intervention, and the rest were treated conservatively. Those who were treated with an invasive intervention were younger and had a lower proportion of chronic heart failure than those treated conservatively. Age > 75 years compared to younger patients, pre-existing heart failure, and higher heart rate upon presentation were associated with lower odds of receiving invasive intervention. Hypertension (OR = 2.86, 95% CI [1.45-5.62]) and STEMI vs. NSTEMI (1.96, [1.10-3.68]) were associated with higher odds of invasive intervention. The adjusted odds of 30-day mortality were lower with invasive intervention compared to conservative treatment (0.25, [0.10-0.67]). Conclusions: One-third of the patients with in-hospital AMIs received conservative treatment. Younger age, absence of heart failure, lower heart rate, hypertension, and STEMI were determinants of invasive intervention usage. Invasive intervention had lower odds of 30-day mortality, but longitudinal studies are still needed to assess the efficacy of conservative vs. invasive strategies in in-hospital AMIs.
摘要：
背景/目标：院内心肌梗塞（AMI）较少采用侵入性干预治疗，与院外AMI相比。我们旨在确定院内AMI患者的侵入性干预的决定因素，并评估其与死亡率的关系。与保守治疗相比。方法：这是萨克森州-安哈尔特州区域性心肌梗死登记处医院内AMI的横断面研究。根据治疗策略（侵入性干预与保守治疗)。进行Logistic回归评估侵入性干预的决定因素(与保守治疗）及其与30天死亡率的关系。结果：近67%的患者（259/386）接受了侵入性干预，其余的都是保守的。接受侵入性干预治疗的人比保守治疗的人更年轻，慢性心力衰竭的比例更低。与年轻患者相比，年龄>75岁，预先存在的心力衰竭，出现时心率较高与接受侵入性干预的几率较低相关.高血压（OR=2.86，95%CI[1.45-5.62]）和STEMI与NSTEMI（1.96，[1.10-3.68]）与较高的侵入性干预几率相关。与保守治疗相比，侵入性干预治疗30天死亡率的校正几率较低（0.25，[0.10-0.67]）。结论：三分之一的住院AMI患者接受保守治疗。年龄更小,没有心力衰竭,降低心率,高血压,和STEMI是侵入性干预使用的决定因素。侵入性干预的30天死亡率较低，但仍需要纵向研究来评估保守与保守的疗效。医院AMI的侵入性策略。
