Total Ischaemic Time and Cardiac Mortality among STEMI Patients in Sarawak Heart Centre, Malaysia

Abstract

Background

Earlier revascularisation was shown to confer better survival outcomes which encourage the effort to reduce the total ischaemic time (TIT). The objective of this study is to evaluate the association of TIT with in-hospital and 30-day mortalities among STEMI patients and to provide insight into the local geographical distribution of STEMI patients at symptom onset.

Methods

All STEMI patients who presented to or were referred to Sarawak Heart Centre from 1^st July 2022 – 31^st December 2022 were recruited. We examined the clinical characteristics of the patients, factors that contributed to TIT, the geographical distribution of patients, and survival outcomes. Multivariate logistic regression was used to analyse the association between TIT and mortality outcomes.

Results

The sample comprised a total of 183 patients. The odds of mortality from TIT of >6 hours were 2.6 times higher than those with TIT of ≤6 hours although the association was not significant. Killip class was a stronger independent predictor of survival outcomes. However, the sizably large odds ratio of TIT with mortality cannot be overlooked.

Conclusion

The higher odds of mortality for patients with prolonged TIT encourage the effort to set up a local STEMI network to reduce the pre-hospital delay.