In-hospital and 30-day major adverse cardiac events in patients referred for ST-segment elevation myocardial infarction in Dhaka, Bangladesh

• Published in: BMC cardiovascular disorders Vol. 21; no. 1; pp. 85 - 9
• Main Authors: Akhtar, Zubair, Aleem, Mohammad Abdul, Ghosh, Probir Kumar, Islam, A. K. M. Monwarul, Chowdhury, Fahmida, MacIntyre, C. Raina, Fröbert, Ole
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 10.02.2021; BioMed Central; BMC
• Subjects: Age; Cardiovascular disease; Cardiovascular diseases; Care and treatment; Congestive heart failure; Coronary vessels; Developing countries; Diabetes; Diabetes mellitus; Education; Electrocardiography; Family medical history; Glucose; Heart attack; Heart attacks; Heart failure; Hospital patients; Hospitals; LDCs; Low-income setting; MACE; Mortality; Multivariate analysis; Myocardial infarction; Patient outcomes; Patients; Physicians; Plasma; Principal components analysis; Risk factors; Sociodemographics; Statistics; STEMI; Ultrasonic imaging; Urban setting; Bangladesh; Dhaka Bangladesh; STEMI; Low-income setting; Urban setting; MACE
• ISSN: 1471-2261; 1471-2261
• DOI: 10.1186/s12872-021-01896-9

There is a paucity of data regarding acute phase (in-hospital and 30-day) major adverse cardiac events (MACE) following ST-segment elevation myocardial infarction (STEMI) in Bangladesh. This study aimed to document MACE during the acute phase post-STEMI to provide information. We enrolled STEMI patients of the National Institute of Cardiovascular Disease, Dhaka, Bangladesh, from August 2017 to October 2018 and followed up through 30 days post-discharge for MACE, defined as the composite of all-cause death, myocardial infarction, and coronary revascularization. Demographic information, cardiovascular risk factors, and clinical data were registered in a case report form. The Cox proportional hazard model was used for univariate and multivariate analysis to identify potential risk factors for MACE. A total of 601 patients, mean age 51.6 ± 10.3 years, 93% male, were enrolled. The mean duration of hospital stay was 3.8 ± 2.4 days. We found 37 patients (6.2%) to experience an in-hospital event, and 45 (7.5%) events occurred within the 30 days post-discharge. In univariate analysis, a significantly increased risk of developing 30-day MACE was observed in patients with more than 12 years of formal education, diabetes mellitus, or a previous diagnosis of heart failure. In a multivariate analysis, the risk of developing 30-day MACE was increased in patients with heart failure (hazard ratio = 4.65; 95% CI 1.64-13.23). A high risk of in-hospital and 30-day MACE in patients with STEMI exists in Bangladesh. Additional resources should be allocated providing guideline-recommended treatment for patients with myocardial infarction in Bangladesh.