Author + information
- Hassaan Arshad,
- Sara Ayaz Butt and
- Mirela Feurdean
Patients suffering from True Posterior Wall Myocardial Infarction (MI) have been classically described as being at an elevated risk of delayed diagnosis. This is due to absence of ‘traditional’ electrocardiographic infarct signs such as ST-segment elevation, which may result in errors or delays in diagnosis.
The aim of this research is to study comparison of revascularization and in-hospital mortality in patients with True Posterior Wall Myocardial Infarction versus Overall ST Segment Elevated Myocardial Infarction. We examined National Inpatient Sample Database from years 2007 - 2014 and compared baseline characteristics of the aforementioned groups using parametric and non-parametric tests for continuous variables and Chi-Square test for dichotomous variables. Multivariate logistic regression was used to analyze the odds of revascularization and in-hospital mortality for True Posterior Wall MI. Missing values for covariates in the regression analysis were adjusted by using multivariate imputation by chained equations technique to ensure valid statistical inference.
True Posterior Wall MI was present in 20,062 of 2,057,964 (1%) of the STEMI population. Both groups had a median age of 65 years but patients with True Posterior Wall MI were more likely to be women (36% vs 33%, p<0.01) and less likely to have chronic pulmonary disease and congestive heart failure as comorbidities (p<0.01 for all). They were also diagnosed more often in urban hospitals (91% vs 88%, p<0.001) and teaching hospital (51% vs 48%, p<0.01). Our regression results indicate that, after adjustment patients with true Posterior Wall MI were more likely to undergo revascularization (odds ratio 1.32, CI 1.22 to 1.345, p<0.001). However, patients with True Posterior Wall MI who underwent revascularization had greater odds (0.21, CI 0.16 to 0.26, p<0.001) of in-hospital mortality when compared to overall STEMI population (0.17, CI 0.163 to 0.172, p<0.001)
In conclusion patients with True Posterior Wall MI were more likely to receive revascularization but were associated with greater odds of in-hospital mortality.
Poster Hall, Hall F
Monday, March 18, 2019, 9:45 a.m.-10:30 a.m.
Session Title: Acute and Stable Ischemic Heart Disease: Clinical 5
Abstract Category: 02. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1330-370
- 2019 American College of Cardiology Foundation