predictors of 1-year major cardiovascular events after st-elevation myocardial infarction in a specialized cardiovascular center in western iran

Background: identifying the long-term predictors of recurrent cardiovascular events may help improve the quality of care and prevent subsequent events. we aimed to investigate the predictors of 1-year major cardiovascular events (mace) in patients discharged after st-elevation myocardial infarction (stemi) in a tertiary hospital in iran. methods: this registry-based cohort study included consecutive stemi patients between 2016 and 2019 in imam-ali hospital, kermanshah, iran. all patients discharged alive from stemi hospitalization were followed up for 1 year for mace, consisting of all-cause mortality, nonfatal mi, and nonfatal stroke. we estimated the hazard ratio (hr) and the 95% confidence interval (95% ci) using cox proportional-hazard models to evaluate potential predictors, including demographic characteristics, medical history, cardiovascular risk factors, laboratory tests, reperfusion therapy, and medications. results: during 2187.2 person-years, 21 patients were lost to follow-up (success rate =99.1%). of 2274 post-discharge stemi patients (mean age =60.26 y; 21.9% female), 151 (6.6%) experienced mace, including, all-cause mortality (n=115, 5.1%), nonfatal mi (n=20, 0.9%), and nonfatal stroke (n=16, 0.7%). independent predictors of mace were age (hr:1.02; 95% ci: 1.00–1.04), no education vs ≥12 years of formal schooling (hr: 2.07; 95% ci: 1.17–3.67), stroke history (hr: 2.37; 95% ci: 1.48–3.81), the glomerular filtration rate (hr: 0.98; 95% ci: 0.97–1.00), the body mass index (hr: 0.94; 95% ci:, 0.89–0.99), peak creatine kinase-mb (hr: 1.00; 95% ci: 1.00–1.002), thrombolysis vs primary percutaneous coronary intervention (hr: 1.85; 95% ci: 1.21–2.81), and left ventricular ejection fraction <35% vs ≥50% (hr: 2.82; 95% ci: 1.46–5.47). conclusion: age, education, stroke history, the glomerular filtration rate, the body mass index, peak creatine kinase-mb, reperfusion therapy, and left ventricular function can be independently associated with 1-year mace.