Predictors of In-Hospital Mortality in Thai STEMI Patients: Results from TACSR†
Sopon Sanguanwong MD *, Suphot Srimahachota MD**, Wiwun Tungsubutra MD***, Boonchu Srichaiveth MD****, Songsak Kiatchoosakun MD*****
Affiliation : † Thai ACS Registry * Division of Cardiovascular Disease, Department of Medicine, Phramongkutklao Hospital, Bangkok ** Faculty of Medicine, King Chulalongkorn University, Bangkok *** Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok **** Bangkok General Hospital, Bangkok ***** Division of Cardiology, Faculty of Medicine, Khon Kaen University, Khon Kaen
Background : Clinical predictors of high-risk STEMI patients may guide physicians to the type of treatment, as
high-risk patients need more aggressive treatment than low-risk patients. There was no previous registry of
STEMI patients in Thailand.
Objective : To determine the clinical predictors of in-hospital mortality in STEMI patients from the Thai ACS
Registry.
Materials and Methods : A multi-center prospective nationwide Thai Acute Coronary Syndrome Registry (TACSR)
was done between August 1, 2002 and October 31, 2005. The STEMI patients were registered to Thai ACS web
site. Clinical and demographic characteristics, coronary risk factors, presenting symptoms, in-hospital treat-
ments, reperfusion procedures and the patients’ outcomes were recorded and analyzed.
Results : 3,836 STEMI patients were studied. The mean age was 62.2 + 12.8 years and 68% of the patients were
male. The mortality rate of Thai STEMI patients was 17% (86.8% from cardiac causes) and the main cause of
death was pumping failure (61.3%). The patients with older age > 75 years, patients with diabetes, shock, and
cardiac arrhythmias had a higher mortality (29.4, 21.2, 43.4 and 37.24% respectively), while patients who
underwent primary percutaneous coronary intervention (primary PCI) had a lower mortality rate (12.66%).
Patients who received treatment with ASA, beta-blocker, ACE inhibitor/ ARB and statin had lower in-hospital
mortality.
Conclusion : The clinical predictors of high in-hospital mortality in STEMI patients from the TACSR were older
age > 75 years, diabetes, shock, and cardiac arrhythmias. The treatments that can decrease the mortality were
primary PCI, ASA, beta-blocker, ACE inhibitor/ARB and statin.
Keywords : Predictors of in-hospital mortality, STEMI patients, TACSR
