ST-elevation myocardial infarction (STEMI) remains a major cause of cardiovascular mortality despite advances in reperfusion therapy and acute coronary care pathways. A retrospective single-center study presented at the Heart Failure 2026 evaluated clinical characteristics, comorbidities, and procedural factors associated with in-hospital mortality among patients admitted with STEMI.
The analysis included all patients admitted with STEMI to a tertiary hospital between September 2023 and September 2025. Clinical characteristics, cardiovascular risk factors, echocardiographic findings, ischemic timing variables, and procedural data were assessed in relation to in-hospital mortality outcomes.
Findings
- A total of 247 patients were included, and overall in-hospital mortality was 10.5%.
- Diabetes was associated with higher in-hospital mortality (OR: 5.048; 95% CI: 2.175-11.718; p < 0.001), while hypertension was also associated with increased mortality risk (OR: 2.656; 95% CI: 1.027-6.868; p = 0.038).
- Presentation with cardiac arrest was associated with substantially higher mortality, with a mortality rate of 62.5% (p < 0.001).
- Reduced left ventricular ejection fraction on echocardiography was associated with worse outcomes (p = 0.008).
- Activation of the coronary emergency pathway at triage was associated with lower mortality (OR: 0.151; 95% CI: 0.064-0.356; p < 0.001) and shorter door-to-catheterization times (54 vs 163 minutes; p < 0.001).
- Total ischemic time and ECG-to-catheterization time were not significantly associated with mortality.
The findings suggest that cardiovascular risk factors, reduced left ventricular systolic function, and cardiac arrest at presentation were associated with worse in-hospital outcomes in STEMI, while early emergency pathway activation was associated with lower mortality.
