title: Prognosis and high-risk complication identification in unselected patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention.
abstract: OBJECTIVE
  The aim of this study was to evaluate treatment with primary percutaneous coronary intervention (PCI) in unselected patients with ST-segment elevation myocardial infarction (STEMI).
  
  
  METHODS
  We registered complication and mortality rates in all patients with STEMI admitted for primary PCI at a high-volume center over a two-year period (2004 to 2006).
  
  
  RESULTS
  We included 1022 consecutive patients (mean age 64 years; 69% men). In-hospital and one-year mortality were 8% and 12%, respectively. Cardiac arrest, cardiogenic shock, left ventricular ejection fraction <or=40% and atrioventricular block significantly predicted increased one-year mortality in univariate analysis (P < 0.001 for all) and were considered high-risk complications. 65% of patients had no high-risk complications. One-year mortality for patients without high-risk complications was 4% compared with 28% for those with high-risk complications (P < 0.001).
  
  
  CONCLUSIONS
  Unselected patients with STEMI treated with primary PCI have mortality rates corresponding to those reported in randomized clinical studies including transport of patients. Mortality is strongly related to high-risk complications developed during admission. Thus, patients with high-risk complications should receive special attention. The majority of patients (65%) without high-risk complications have an excellent short- and long-term prognosis following primary PCI.
authors: The Heart Centre, Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
authors: Hedvig
authors: H
authors: Andersson
authors: Maria
authors: M
authors: Sejersten
authors: Peter
authors: P
authors: Clemmensen
authors: Peer
authors: P
authors: Grande
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D054537:Atrioventricular Block / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D004562:Electrocardiography; D005260:Female; D006323:Heart Arrest / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D011379:Prognosis; D012307:Risk Factors; D012770:Shock, Cardiogenic / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D014186:Transportation; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology / Q000401:mortality