title: Likelihood and predictors of ST-elevation in patients hospitalized for myocardial infarction.
abstract: OBJECTIVE
  Emergency treatment options in myocardial infarction are guided by presence or absence of ST-elevations in electrocardiography. Occurrence and factors associated with ST-presentation in different population groups are however inadequately known.
  
  
  OBJECTIVE
  To determine likelihood and patient features associated with ST-elevations in myocardial infarction.
  
  
  METHODS
  Nationwide registry study including 22 hospitals with angiolaboratory during an eight year period in Finland.
  
  
  METHODS
  Hospitalized care.
  
  
  METHODS
  68,162 consecutive patients aged ≥ 30 with myocardial infarction.
  
  
  METHODS
  Likelihood and patient features associated with presence of ST-elevations.
  
  
  RESULTS
  Myocardial infarction presented with ST-elevation in 37.5% (CI 37.0-37.9%) and without in 62.5% (CI 61.9-63.1%) of patients, p<0.0001. Majority of patients aged 30-59 years with myocardial infarction had ST-elevation, but among octogenarians ST-elevations were present in only 24.7%. Presence of ST-elevations decreased with age by estimated 15.6% (CI 15.0-16.2%) per 10 year increase (p<0.0001). Men aged 40-79 years had significantly higher rate for ST-elevation myocardial infarction compared to women. Sex-based difference in presentation of myocardial infarction declined with increasing age. Overall, men had a 13% (CI 11-15%, p<0.0001) higher relative risk for ST-elevations compared to women when adjusted for age and co-morbidities. Diabetes, atrial fibrillation, peripheral or cerebral artery disease, chronic pulmonary disease, malignancy, and renal insufficiency were associated with absence of ST-elevations in myocardial infarction in multivariate analysis.
  
  
  CONCLUSIONS
  Myocardial infarction presents with ST-elevations more commonly in men. Presence of ST-elevations decreases with increasing age. Diabetes, atrial fibrillation, peripheral or cerebral artery disease, chronic pulmonary disease, malignancy, and renal insufficiency are associated with absence of ST-elevations in myocardial infarction. These findings may help to predict likelihood of ST-elevations in a patient with myocardial infarction.
authors.affiliation: Heart Center, Division of Clinical Neurosciences, Neurology and Clinical Research Center, Turku University Hospital, Turku, Finland; PET Center, Medicine, Neurology and Public Health, University of Turku, Turku, Finland.
authors.forename: Ville
authors.initials: V
authors.lastname: Kytö
authors.affiliation: Heart Center, Division of Clinical Neurosciences, Neurology and Clinical Research Center, Turku University Hospital, Turku, Finland; PET Center, Medicine, Neurology and Public Health, University of Turku, Turku, Finland.
authors.forename: Jussi
authors.initials: J
authors.lastname: Sipilä
authors.affiliation: Heart Center, Division of Clinical Neurosciences, Neurology and Clinical Research Center, Turku University Hospital, Turku, Finland; PET Center, Medicine, Neurology and Public Health, University of Turku, Turku, Finland.
authors.forename: Päivi
authors.initials: P
authors.lastname: Rautava
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004562:Electrocardiography; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D011379:Prognosis; D012042:Registries; D012307:Risk Factors