Publication:

Determinants associated with ST-elevation myocardial infarction

Background ST-elevation myocardial infarction (STEMI) is an acute coronary syndrome with a high fatality rate and is life-threatening. STEMI-related determinants for South Asian populations are significant to identify when preparing specific prevention strategies. STEMI-related determinants among a Bangladeshi population were the subject matter of this study.

Methods A cross-sectional study was conducted at Sir Salimullah Medical College & Mitford Hospital, Dhaka, from June to December 2018. One hundred STEMI patients aged between 30-70 years who were purposively sampled and had ECG-confirmed ST-segment elevation were enrolled. Those with a previous cardiac event or chronic disease were excluded. Data collection was done through the collection of demographic data, cardiovascular risk factors, clinical measurements, and laboratory investigations. Independent determinants were determined using multivariate logistic regression analysis using SPSS v26.

Results Mean age 52.5±13.1 years with male dominance (59%). Hypertension (HTN) was present in 63%, smoking in 47%, diabetes mellitus (DM) in 42%, and dyslipidemia in 22%. Age strata analysis revealed a significant association between age groups and the distribution of risk factors. Multivariate analysis revealed that age >50 years (AOR=2.85, p=0.008), male gender (AOR=1.74, p=0.001), HTN (AOR=3.25, p=0.004), DM (AOR=2.12, p=0.046), and smoking (AOR=2.50, p=0.012) were independent predictors for STEMI severity.

Conclusions The traditional cardiovascular risk determinants remain the foremost predictors of STEMI among Bangladeshi populations. HTN was the strongest predictor, followed by DM and smoking. The findings emphasize the need for aggressive risk factor modification programs targeting modifiable determinants to reduce STEMI in Bangladesh.