Association between Myocardial Infarction Location and In-Hospital Mortality in Iran: A Nationwide Study

Background: Myocardial infarction (MI) is one of the most important health problems in the world, including Iran. The rate of in-hospital mortality in MI patients ranges from 7.7% to 19.2% in different countries. Despite the promotion and utilization of new therapeutic approaches, MI-related morbidity and mortality have remained high . The recognition of risk factors for MI-related mortality plays an important role in reducing post-MI mortality. Methods: In this study, we used national MI registry data. In total, 33,831 patients who had been hospitalized in the coronary care unit of Iranian hospitals from 2012 to 2014 were analyzed. Using multivariable logistic regression, we estimated the impact of various risk factors on in-hospital mortality after MI. Results: The in-hospital mortality rate in patients with ST-elevation MI was higher than that of patients with non–ST-elevation MI. In-hospital mortality was most strongly associated with left-location MI (odds ratio [OR] relative to the non-ST-elevation MI group, 2.15), in comparison with middle-location MI (OR, 1.47) and right-location MI (OR, 1.43). Ventricular fibrillation (OR, 7.7) and ventricular tachycardia (OR, 2.78) were predictors of in-hospital mortality. Receiving treatment reduced the odds of death and age, sex, and diabetes were risk factors associated with in-hospital mortality after MI. Conclusions: Age, sex, right bundle branch block arrhythmia, atrial fibrillation, ventricular tachycardia, left bundle branch block arrhythmia, ventricular fibrillation, dyspnea, diabetes, and ST-elevation MI were associated with increased ORs for mortality after MI. Thus, patients with these factors require special attention during hospitalization.