In-hospital Outcomes of Patients with ST-segment Elevation Myocardial Infarction who were Intubated before Primary Percutaneous Intervention: Experience of a tertiary center

Özet

Objectives: ST-segment elevation myocardial infarction (STEMI) complicated by respiratory failure is associated with a greaternumber of in-hospital and out-of-hospital adverse cardiovascular events (CVEs). The aim of this study was to analyze in-hospitaloutcomes and the factors affecting the outcomes of intubated patients diagnosed with STEMI who underwent primary percutaneous coronary intervention (pPCI) at a single tertiary care center.Methods: The data of 592 patients diagnosed with acute STEMI who were admitted to the emergency department between May2017 and January 2019 and subsequently underwent pPCI were retrospectively reviewed. Cardiovascular risk factors as well asbiochemical and angiographic characteristics of patients who were intubated in the emergency room or ambulance due to cardiacarrest and those who were not intubated were compared. Adverse CVEs were defined as in-hospital death, cerebrovascular stroke,and acute stent thrombosis.Results: A total of 60 patients (70% male; mean age: 63.6±14.0 years) who were intubated and 532 non-intubated patients (81%male; mean age: 60.2±12.1 years) were included in the study. The angiographic features of the 2 groups were similar. An adverseCVE was experienced by 43.3% of the intubated patients and 3.6% of the non-intubated patients. Multivariate analysis indicatedthat age (odds ratio [OR]: 1.065; p<0.001), serum lactate level (OR: 1.308; p<0.001), and left ventricle ejection fraction (OR: 0.946;p<0.001) were independent predictors of in-hospital adverse CVE in the intubated patient group.Conclusion: The results of this single-center study showed that 1 in 10 patients hospitalized with STEMI were intubated, and approximately 4 in 10 intubated STEMI patients had an in-hospital CVE.