Impact of high heart rate at admission on in-hospital mortality after PCI for acute STEMI

Introduction: ST-segment elevation myocardial infarction, the severe form of coronary artery disease, carries high morbidity and mortality. Primary percutaneous coronary intervention is the preferred treatment for better survival. Recent research suggests a high heart rate upon admission predicts in-hospital mortality with PCI in STEMI patients. However, limited evidence and lack of local data prompted this study. Methodology: Research at the Department of Cardiology, Punjab Institute of Cardiology, Lahore from 03/12/2019 to 02/06/2020 involved 196 patients (aged 30-60) undergoing percutaneous coronary intervention for acute STEMI. Heart rate was monitored upon admission, with ?80 bpm considered high. In-hospital mortality (death within 48 hours of admission) was compared between patients with and without high heart rate. Written consent was obtained from each patient. Results: The mean age of patients was 53.4±6.9 years, with a male predominance at a ratio of 2.1:1. Out of the patients, 78.1% were obese, and 52.6% were smokers. High heart rate (?80 bpm) was seen in 53.6% patients, and 9.7% with STEMI undergoing PCI had in-hospital mortality. In-hospital mortality was significantly higher in STEMI patients with high heart rate (15.2% vs. 3.3%; p=0.005). Conclusion: In this study, many acute STEMI patients had high heart rates at admission, leading to increased in-hospital mortality rates. Regular monitoring of heart rate in STEMI cases is advised to improve outcomes, especially for high-risk patients with elevated heart rates at admission. Keywords: ST Elevation Myocardial Infarction, Percutaneous Coronary Intervention, In-Hospital Mortality, Heart Rate.