{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,22]],"date-time":"2025-02-22T00:14:44Z","timestamp":1740183284022,"version":"3.37.3"},"reference-count":0,"publisher":"Maad Rayan Publishing Company","issue":"11","content-domain":{"domain":["aimjournal.ir"],"crossmark-restriction":false},"short-container-title":["Arch Iran Med"],"published-print":{"date-parts":[[2021,11,1]]},"abstract":"<jats:p>Background: Considerable variability in survival rate after ST-segment elevation myocardial infarction (STEMI) is present and outcomes remain suboptimal, especially in low- and middle-income contraries. This study aimed to investigate predictors of 30- day mortality after STEMI, including reperfusion therapy, in a tertiary hospital in western Iran. Methods: In this registry-based cohort study (2016\u20132019), we investigated reperfusion therapies \u2013 primary percutaneous coronary intervention (PPCI), pharmaco-invasive (thrombolysis followed by angiography\/percutaneous coronary intervention), and thrombolysis alone \u2013 used in Imam-Ali hospital, the only hospital with a PPCI capability in the Kermanshah Province. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs), using Cox proportional-hazard models, to investigate the potential predictors of 30-day mortality including reperfusion therapy, admission types (direct admission\/referral from non-PPCI-capable hospitals), demographic variables, coronary risk factors, vital signs on admission, medical history, and laboratory tests. Results: Data of 2428 STEMI patients (mean age: 60.73; 22.9% female) were available. Reperfusion therapy was performed in 84% of patients (58% PPCI, 10% pharmaco-invasive, 16% thrombolysis alone). Only 17% of the referred patients had received thrombolysis at non-PPCI-capable hospitals. Among patients with thrombolysis, only 38.2% underwent coronary angiography\/ percutaneous coronary intervention. The independent predictors of mortality were: no reperfusion therapy (HR: 2.01, 95% CI: 1.36\u20132.97), referral from non-PPCI-capable hospitals (1.73, 1.22\u20132.46), age (1.03, 1.01\u20131.04), glomerular filtration rate (0.97, 0.96\u20130.97), heart rate&gt;100 bpm (1.94, 1.22\u20133.08), and systolic blood pressure&lt;100 mm Hg (4.92, 3.43\u20137.04). Mortality was lower with the pharmaco-invasive approach, although statistically non-significant, than other reperfusion therapies. Conclusion: Reperfusion therapy, admission types, age, glomerular filtration rate, heart rate, and blood pressure were independently associated with 30-day mortality. Using a comprehensive STEMI network to increase reperfusion therapy, especially pharmaco-invasive therapy, is recommended. <\/jats:p>","DOI":"10.34172\/aim.2021.119","type":"journal-article","created":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T06:47:53Z","timestamp":1638168473000},"page":"796-803","update-policy":"https:\/\/doi.org\/10.34172\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reperfusion Therapy and Predictors of 30-Day Mortality after ST-Segment Elevation Myocardial Infarction in a University Medical Center in Western Iran"],"prefix":"10.34172","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4757-6336","authenticated-orcid":true,"given":"Nahid","family":"Salehi","sequence":"first","affiliation":[{"name":"Cardiovascular Research Center, Health Institute, Imam-Ali hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sayeh","family":"Motevaseli","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Center, Health Institute, Imam-Ali hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parisa","family":"Janjani","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Center, Health Institute, Imam-Ali hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mostafa","family":"Bahremand","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Center, Health Institute, Imam-Ali hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reza","family":"Heidari Moghadam","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Center, Health Institute, Imam-Ali hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad","family":"Rouzbahani","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Center, Health Institute, Imam-Ali hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soraya","family":"Siabani","sequence":"additional","affiliation":[{"name":"Department of Health Education and Health Promotion, Kermanshah University of Medical Sciences, Kermanshah, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hooman","family":"Tadbiri","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7464-9756","authenticated-orcid":true,"given":"Mahdi","family":"Nalini","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Center, Health Institute, Imam-Ali hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"20123","published-online":{"date-parts":[[2021,11,1]]},"container-title":["Archives of Iranian Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/aimjournal.ir\/PDF\/aim-24-796.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/aimjournal.ir\/PDF\/aim-24-796.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T06:47:53Z","timestamp":1638168473000},"score":1,"resource":{"primary":{"URL":"http:\/\/aimjournal.ir\/Article\/aim-20965"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,1]]},"references-count":0,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,11]]}},"URL":"https:\/\/doi.org\/10.34172\/aim.2021.119","relation":{},"ISSN":["1029-2977","1735-3947"],"issn-type":[{"type":"print","value":"1029-2977"},{"type":"electronic","value":"1735-3947"}],"subject":[],"published":{"date-parts":[[2021,11,1]]},"assertion":[{"value":"Academy of Medical Sciences of I.R. Iran","name":"journal_owner","label":"Journal Owner"},{"value":"Academy of Medical Sciences of I.R. Iran","name":"journal_publisher","label":"Journal Publisher"},{"value":"2021-01-31","order":1,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-11-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}