Abstract
OBJECTIVE: Acute coronary syndrome is a potentially fatal disease if it is not intervened in a timely and appropriate manner. In Colombia in 2021, 51,988 deaths were recorded from this cause. The aim is to compare the clinical characteristics of ST-elevation myocardial infarction (STEMI) and non-ST elevation acute myocardial infarction (NSTEMI) and percutaneous coronary intervention (PCI), determining in-hospital (< 30 days) survival with factors associated with mortality. METHODS: Prospective cohort study (2020-2021), with survival analysis using the Kaplan-Meier method and Cox regression model to determine predictive factors that impacted in-hospital mortality in a high-complexity institution, Medellín, Colombia. RESULTS: Of 504 participants, 53% had STEMI, and 47% had NSTEMI. Median age 64 years (interquartile range 57-73), 66% were men. In-hospital survival in NSTEMI was 98.3% (95% confidence interval [CI]: 97-100), and STEMI was 93.7% (95% CI: 91-97). Significant predictors that impacted in-hospital mortality for STEMI were: Age > 65 years (hazard ratio [HR]: 3.47 p: 042), Diabetes (HR: 5.07 p: 0.002), Killip IV (HR: 21.6 p < 0.001) and post-PCI Arrhythmia (HR: 6 p: 0.002). In contrast, predictors for NSTEMI were Cardiogenic Shock (HR: 23.3 p: 0.047) and post-PCI arrhythmia (HR: 23.4 p: 0.047). CONCLUSION: Patients with Killip IV NSTEMI and post-PCI arrhythmia constitute a group at higher cardiovascular risk with a higher in-hospital mortality than STEMI patients. Furthermore, diabetes is a modifiable risk factor that could impact early survival in STEMI patients after PCI.