The Pattern of In-Hospital Mortality of Myocardial Infarction and Associated Factors in Iran: A National Study

No comprehensive and population-based study has been so far conducted in Iran to determine the epidemiologic pattern of myocardial infarction (MI) and particularly in-hospital mortality rate and the effective factors. This study aimed to determine the epidemiologic pattern and associated risk factors. This prospective, population-based cohort study used the data of 20750 patients with MI in Iran in 2012. The in-hospital mortality rate was calculated using Cox regression. Univariate analysis of variances and multiple logistic regression were used to determine the effective factors on the patients’ mortality. The odds ratio and 95% confidence interval (CI) were reported using Stata software. 15033 patients (72.4%) were men. The mean age of the patients was 61.2 ± 13.4 years. The case fatality rate of in-hospital mortality was 12.1%. The in-hospital mortality rate was higher in women and was 6.74% (95% CI: 6.4-7%) in at-risk patients. Age of over 84 years, being female, educational level, smoking, lack of thrombolytic therapy, diabetes type 2, chest pain prior to arriving in hospital, right bundle branch block, ventricular tachycardia, percutaneous coronary intervention (PCI), lateral MIs, and ST segment elevation (STEMI) were determinants of in-hospital mortality in the patients. In view of the results obtained in this study, it seems that STEMI, lack of thrombolytic therapy, the age of over 84 years, and ventricular tachycardia have the highest impact on in-hospital mortality of the patients with MI. The results of this study are helpful in planning for monitoring and promoting healthcare and treatment for the patients.