Limited data exists regarding the time-point risk stratification model after acute coronary syndrome. This study aimed to investigate time-point mortality rates in patients with acute myocardial infarction, focusing on comparison by type of myocardial infarction, in a real-world cohort. A total of 12,836 patients from a nationwide Korean registry were analyzed. Mortality rates were calculated at yearly, monthly, and weekly time points after admission in patients with ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI), dividing the number of deaths during a specific period by the number of patients at risk in the same period. In the first week after admission, patients with STEMI had a significantly higher mortality rate than NSTEMI patients (4.62% vs. 1.79%, P <0.001). However, this trend had been inverted since the second week. The higher mortality rate in patients with STEMI versus NSTEMI was inverted since the second week for male but not for female patients, where the inversion occurred since the tenth week. Temporal assessment of correlates of mortality revealed that several baseline variables, including Killip class, systolic blood pressure, total cholesterol, and STEMI diagnosis, had significantly different impacts on deaths over time. In conclusion, temporal assessment of time-point outcomes from the Korean registry revealed that an initially higher mortality rate in patients with STEMI versus NSTEMI had been inverted at second week. This outcome assessment could be one step toward advanced risk prediction model for time-course personalized medicine. Further studies are needed to clarify this issue.
Keywords: Acute Coronary Syndrome; Non-ST-elevation myocardial infarction; Outcome Assessment, Health Care; Registries; ST-elevation myocardial infarction.
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