Five-Year Clinical Outcomes and Factors Associated With Major Adverse Cardiovascular Events in Transient ST-Segment Elevation Myocardial Infarction: A Retrospective Cohort Study

Aim: This study aimed to evaluate five-year clinical outcomes and investigate baseline factors associated with major adverse cardiovascular events (MACE) in patients presenting with transient ST-segment elevation myocardial infarction (STEMI).Material and Methods: This retrospective, single-center, observational study included 52 patients who presented between January 2019 and December 2020 with ST-segment elevation on the initial electrocardiogram followed by complete resolution before coronary angiography. The primary outcome was five-year MACE, defined as a composite of cardiovascular death, acute coronary syndrome, revascularization, and ischemic cerebrovascular events. Follow-up data were obtained from hospital records and the national electronic health record system. Patients with and without MACE were compared, and associated factors were examined using univariable logistic regression.Results: The median age was 54.5 years, and 80.8% of patients were male. During five-year follow-up, MACE occurred in 11 patients (21.2%). All-cause mortality was 7.7%, cardiovascular mortality was 1.9%, and acute coronary syndrome and revascularization each occurred in 15.4%. Patients with MACE were older (63.0 vs. 51.0 years; p=0.003) and more frequently had hypertension (72.7% vs. 29.3%; p=0.014) and hyperlipidemia (45.5% vs. 12.2%; p=0.025). In univariable analysis, age (OR: 1.09; 95% CI: 1.02-1.17; p=0.016), hypertension (OR: 6.44; 95% CI: 1.46-28.53; p=0.014), and hyperlipidemia (OR: 6.00; 95% CI: 1.32-27.19; p=0.020) were significantly associated with five-year MACE.Conclusion: Long-term cardiovascular risk was not negligible after transient STEMI despite resolution of ST-segment elevation. Age, hypertension, and hyperlipidemia were associated with five-year MACE in univariable analyses and may help identify patients at higher long-term cardiovascular risk.