Prevalence and Risk Factors of In-Hospital Mortality of ST Elevation Myocardial Infarction (STEMI) Patients in Bekasi Regency General Hospital in 2021

Khanza Rizqullah Syauqi *

Bekasi Regency General Hospital, Bekasi Regency, Indonesia.

Mailani Karina Akhmad

Bekasi Regency General Hospital, Bekasi Regency, Indonesia.

Omar Mokhtar Siregar

Bekasi Regency General Hospital, Bekasi Regency, Indonesia.

*Author to whom correspondence should be addressed.


Abstract

Background: Acute Coronary Syndrome (ACS) is a major cardiovascular problem and has been one of the leading death in the world. ST-Elevation Myocardial Infarction (STEMI) is an indicator of total coronary artery occlusion which requires revascularization to restore the blood flow and myocardial reperfusion using fibrinolytic agents or primary Percutaneous Coronary Intervention (PCI). Early treatment showed better outcomes and reduced in-hospital mortality in ACS patients.

Aims: To determine the prevalence of Acute Coronary Syndrome (ACS) patients and the risk factors of in-hospital mortality of ST-Elevation Myocardial Infarction (STEMI) patients at Bekasi Regency General Hospital in 2021.

Place and Duration of Study: Cardiology Department and Emergency Room Unit in Bekasi Regency General Hospital, December 2021 to March 2022

Methods: This study is a descriptive cross-sectional study using secondary data (medical records) which included all the patients over 35 years old that admitted through the ER from January to December 2021 with complaints including chest pain or shortness of breath which were later hospitalized. The final sample used in this study is 117 subjects.

Results: There were 117 cases of ACS in 2021. They were 14% STEMI, 15% Non-ST Elevation Myocardial Infarction (NSTEMI), and 71% Unstable Angina Pectoris (UAP). Most patients were male (54%), and aged <65 years old (85%). The in-hospital mortality was 19% STEMI, 17% NSTEMI, and 12% UAP. Among 16 STEMI patients, 81% were male and 94% were aged <65 years old. There were 69% who came to the emergency room <12 hours and only 50% underwent fibrinolytic.

Conclusion: The risk factors of in-hospital mortality of STEMI patients were 40% late onset, 23% anterior STEMI, 20% hypertension, 60% diabetes mellitus, 50% chronic kidney disease, 33% tachycardia, and 100% Killip III.

Keywords: Acute coronary syndrome, St-Elevation myocardial infarction, in-hospital mortality, prevalence, risk factors


How to Cite

Syauqi , K. R., Akhmad , M. K., & Siregar , O. M. (2023). Prevalence and Risk Factors of In-Hospital Mortality of ST Elevation Myocardial Infarction (STEMI) Patients in Bekasi Regency General Hospital in 2021. Cardiology and Angiology: An International Journal, 12(4), 285–294. https://doi.org/10.9734/ca/2023/v12i4369


References

World Health Organization. Cardiovascular Diseases (CVDs); 2021.

Available:https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)

Bueno H. Epidemiology of acute coronary syndromes. In The ESC Textbook of Cardiovascular Medicine (3rd edition ). The European Society of Cardiology Series/. 2018;1214–1218.

Available:https://doi.org/https://doi.org/10.1093/med/9780198784906.003.0305

World Health Organization. (2020). Global Health Estimates 2020: Deaths by Cause, Age, Sex, by Country and by Region; 2000-2019. World Health Organization. Available:https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates/ghe-leading-causes-of-death

Maulidia R. QRS complex fragmentation as a predictor of mortality and rehospitalisation in the first 6 months in acute coronary syndrome (STEMI, NSTEMI) in Haji Adam Malik General Hospital, Medan. Universitas Sumatera Utara; 2021.

Wibowo A, Andina M. Prevalence of hypertension with Acute Coronary Syndrome (ACS) in Hajj Hospital, Medan. Jurnal Kedokteran Anatomica. 2018;1(3).

Indonesian Cardiovascular Specialist Association. Clinical Practice Guideline (CPGs) and Clinical Pathway (CP) in cardiovascular disease (1st ed.) (1st ed.). Indonesian Cardiovascular Specialist Association; 2016.

Elfi EF. Acute coronary syndrome with complications of acute pulmonary edema and cardiac arrest. Jurnal Kesehatan Andalas. 2015;4(2):613–617. Available:https://doi.org/10.25077/jka.v4i2.309

Gayatri NI, Firmansyah SSSH, Rudiktyo E. Predictors of in-hospital mortality in acute ST-Elevation Myocardial Infarction (STEMI) patients in Dr. Dradjat Prawiranegara Regional General Hospital, Serang, Indonesia. Cermin Dunia Kedokteran Journal. 2016;43(3): 171–174.

Kurniawan LB, Bahrun U, ER D, Arif M. The relationship between Creatine Kinase-MB levels and mortality in patients with myocardial infarction during hospitalization in Dr. Wahidin Sudirohusodo Hospital, Makassar. Buletin Penelitian Kesehatan. 2015;43(2):125–130. Available:https://doi.org/10.22435/bpk.v43i2.4146.125-130

Indonesian Cardiovascular Specialist Association. Guidelines for acute coronary syndrome management (4th ed.) (Keempat). Indonesian Cardiovascular Specialist Association; 2018.

Salari N, Morddarvanjoghi F, Abdolmaleki A, Rasoulpoor S, Khaleghi AA, Hezarkhani LA, Shohaimi S, Mohammadi M. The global prevalence of myocardial infarction: a systematic review and meta-analysis. BMC Cardiovascular Disorders. 2023;23(206). Available:https://doi.org/https://doi.org/10.1186/s12872-023-03231-w

Fahri I. STEMI in Indonesia - Social-Economics & demographics challenges. Transcatheter Cardiovascular Therapeutics Asia Pacific; 2022. Available:https://www.summitmd.com/html/technical/coronary/inside_topics_view.php?cmode=slide&subset=&part=e&year=&no_case=8625

Wilar GI, Panda AL, Rampengan SH. 6 Months observation of Major Cardiovascular Events in patients with Acute ST-Elevation Myocardial Infarction (STEMI) in Prof. Dr. R. D. Kandou General Hospital, Manado during January-December 2017 period. Jurnal Medik Dan Rehabilitasi (JMR). 2019;1(3):1–8.

Dharma S, Juzar DA, Firdaus I, Soerianata S, Wardeh AJ, Jukema JW. Acute myocardial infarction system of care in the third world. Netherlands Heart Journal. 2012;20(6):254–259. Available:https://doi.org/10.1007/s12471-012-0259-9

Torry SRV, Panda L, Ongkowijaya J. Description of risk factors of patients with Acute Coronary Syndrome. Jurnal E-CliniC (ECl). 2014;2(1):1–8.

Pramudyo M, Yahya AF, Martanto E, Tiksnadi BB, Karwiky G, Rafidhinar R, Putri GNI. Predictors of in-hospital mortality in patients with acute coronary syndrome in Hasan Sadikin Hospital, Bandung, Indonesia: A retrospective cohort study. Acta Medica Indonesiana. 2022;54(3):379–388.

Tessy DB, Pramudyo M, Cool CJ. Characteristics of in-hospital mortality among patients with acute coronary syndrome: A Single-Center Study in West Java, Indonesia. Althea Medical Journal. 2021;8(2):99–103.

Available:https://doi.org/https://doi.org/10.15850/amj.v8n2.2281

Suling FRW, Patricia MI, Suling TE. Prevalence and risk factors of acute coronary syndrome at Universitas Kristen Indonesia General Hospital. Majalah Kedokteran UKI. 2018;34(3): 110–114.

Sutarmini SANY, Gunadhi IGNP. ST-Segment elevation as a predictor of Major Adverse Cardiovascular Events (MACE) in Acute Coronary Syndrome (ACS) patients during hospitalization in Sanglah General Hospital, Denpasar. Udayana University; 2017.

Adam AA, Tiluata LJ, Yunita L, Putra MP, Wilujeng N, Homalessy LV, Hutabarat DCF. Clinical Pro_le of Acute Coronary Syndrome Patients in Kupang: a Result from 1-Year iSTEMI Registry. Indonesian Journal of Cardiology. 2021;42(4):109–118. Available:https://doi.org/https://doi.org/10.30701/ijc.1194

Noordzij M, Dekker FW, Zoccali C, Jager KJ. Measures of disease frequency: Prevalence and incidence. Nephron Clinical Practice. 2010;115(1):c17–c20. Available:https://doi.org/https://doi.org/10.1159/000286345