Abstract

Cardiovascular disease is still the leading cause of death. In our tertiary care centre, we
looked at the change in outcomes for anterior ST-elevation myocardial infarction
(STEMI) between January 2017 and December 2021. Over the last five years, 1,658
patients with anterior STEMI who presented to our centre underwent primary
percutaneous coronary intervention within 12 hours of their arrival. We gathered
demographic, clinical, and mortality data during a five-year period and divided it into
four quartiles: 2017-2018 (n=312), 2019 (n=408), 2020 (n=428), and 2021 (n=510).
The average age declined across the four quartiles (64.4, 62, 60.3, and 60 years,
respectively, p<0.01). There was a significant increase in the prevalence of smoking,
hypertension, and obesity in all groups, but no change in diabetes. The median hospital
stay was shorter (6, 4.4, 4.2, and 3.6 days, respectively, p<0.01), as was the median doorto-
balloon time (DBT) (217, 194, 135, and 38 minutes, respectively, p<0.01). Thirty-day
and one-year mortality rates improved over time (14.4, 11.8, 8.4, and 7.8%) and (20.5,
16.4, 15.9, and 13.9 percent) respectively (p=0.01). In addition, 3-year mortality
decreased (25.3, 21.6, 21.3, and 16.5 percent, respectively, p=0.02).Shorter DBT was
associated with lower long-term mortality after adjusting for age, gender, comorbidities,
ejection fraction, clinical shock, and mitral regurgitation (compared to
DBT <60 minutes; 60-90 minutes HR 1.67, 95 percent CI 0.93-3.00, p=0.084; 90-120
minutes, HR 1.74, 95 percent CI 1.02-2.95, p=0.04; >120 minutes, HR 1.91, 95 percent
CI 1.23-2. In conclusion, patients with anterior STEMI have had better long-term
results when DBT has been shortened over the last fiveyears.