Mortality Trends in Patients Hospitalized with the Initial Acute Myocardial Infarction in a Middle Eastern Country over 20 Years

Abstract EN

We aimed to define the temporal trend in the initial Acute Myocardial Infarction (AMI) management and outcome during the last two decades in a Middle Eastern country.

A total of 10,915 patients were admitted with initial AMI with mean age of 53 ± 11.8 years.

Comparing the two decades (1991–2000) to (2001–2010), the use of antiplatelet drugs increased from 84% to 95%, β-blockers increased from 38% to 56%, and angiotensin converting enzyme inhibitors (ACEI) increased from 12% to 36% (P<0.001 for all).

The rates of PCI increased from 2.5% to 14.6% and thrombolytic therapy decreased from 71% to 65% (P<0.001 for all).

While the rate of hospitalization with Initial MI increased from 34% to 66%, and the average length of hospital stay decreased from 6.4 ± 3 to 4.6 ± 3, all hospital outcomes parameters improved significantly including a 39% reduction in in-hospital Mortality.

Multivariate logistic regression analysis showed that higher utilization of antiplatelet drugs, β-blockers, and ACEI were the main contributors to better hospital outcomes.

Over the study period, there was a significant increase in the hospitalization rate in patients presenting with initial AMI.

Evidence-based medical therapies appear to be associated with a substantial improvement in outcome and in-hospital mortality.