Assessment of coronary care management and hospital mortality from ST-segment elevation myocardial infarction in the Kazakhstan population: Data from 2012 to 2015

Objective: The aim of this study was to assess and evaluate factors related to coronary care management and hospital mortality in patients with ST-segment elevation myocardial infarction (STEMI) hospitalized in the Kazakhstan County and city hospitals in which percutaneous coronary intervention (PCI) was performed during the period of 2012–2015. Materials and methods: A total of 22,176 adult patients (18> years) with acute STEMI were hospitalized from January 2012 to December 2015. All the investigated STEMI patients underwent PCI.Results: The mean age of STEMI patients was 61.52
± 11.48 years, 72.2% of the patients were male and 75.2% living in the rural regions. The mean time from hospitalization to PCI was 2104.41 ±
5060.68 min (median 95.0 and IQR 1034.5). The mean and median of time from hospitalization to PCI tended to decrease from 2747.7 ±
5793.9 min and 155.0 min in 2012 to 1874.7
± 4759.2 min and 73.5 min in 2015. Among all STEMI events the percentage of patients from hospitalization to PCI within 0–59 min was up to 39.0% during all study period. From 2012 to 2015, the percentage of STEMI patients with short time (0–59 min) of hospitalization to PCI tended to increase in average by 11.4% per year (P = 0.09). Among all STEMI patients hospital mortality from 2012 to 2015 did not change significantly and ranged from 9.0% in 2012 to 8.6% in 2015. By multiple logistic regression analysis, study years (2012), gender (female), age (60> years), time from hospitalization to PCI (60> min) and number of bed-days were statistically significant factors associated with patients' hospital mortality from STEMI with PCI.Conclusions: The present study demonstrated that hospitalization delay in the treatment of STEMI patients in Kazakhstan population was without significant changes, meanwhile the number of patients perfused within 1 h from hospitalization to PCI tended to increase during 2012–2015. The higher hospital mortality was associated with study year, female gender, older age, longer-time from hospitalization to PCI and shorter hospitalization.