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Cardiac insufficiency is the most common and most severe complication of patients with acute ST segment elevation myocardial infarction (STEMI). So far, there has been little data on the incidence and prognosis of cardiac insufficiency in patients with STEMI in primary percutaneous coronary intervention (PCI) era. Aim: The aim of this investigation is to determine the incidence and impact of cardiac insufficiency on one-year mortality in patients with STEMI treated with primary PCI method. Material and methods: Data on consecutive patients with STEMI was analyzed who were treated with primary PCI in the Coronary Care Unit of the Emergency Center in Belgrade, due to acute STEMI. The assessment of cardiac insufficiency was done according to the Killip classification. The primary outcome of the study was one-year mortality. Results: Out of 700 consecutive patients with STEMI treated with primary PCI, cardiac insufficiency occurred in 160 patients (22.9%). One-year mortality in patients with heart failure was significantly higher than in patients who did not develop this complication (34.4% versus 5.4%; p < 0.001). Using the multivariate Cox regression analysis, independent predictors of one-year mortality were isolated. Cardiac insufficiency was the strongest predictor of mortality. Patients with cardiac insufficiency were at the seven-fold higher risk of fatal outcome compared to patients without heart failure (HR 7.16; 95% CI 4.47-11.48; p < 0.001). Conclusion: Cardiac insufficiency is a frequent complication of acute ST segment elevation myocardial infarction in the primary PCI era. The occurrence of cardiac insufficiency as a complication of STEMI is associated with a seven-fold higher risk for one-year mortality.

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Influence of cardiac insufficiency as a complication of acute myocardial infarction on one-year mortality in patients treated with primary percutaneous coronary intervention