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Objectives Little is known about the mortality rate of ST-segment elevation myocardial infarction (STEMI) in older people form low- and middle-income countries. Therefore, this study aims to investigate the predictors of one-year mortality in older people with STEMI in Kermanshah, Iran. Methods & Materials This is a cohort study that was conducted on 421 older patients with STEMI admitted to Imam-Ali Hospital in Kermanshah from July 3, 2018, to December 21, 2019. Descriptive statistics were used to report the risk factors, and univariate and multiple Cox proportional-hazards model were used to investigate predictors of one-year mortality. Results The patients had a mean age of 73.51±6.73 years. The majority of them were male (67.5%), residents of Kermanshah (74.9%), and illiterate (60.8%). Reperfusion therapy was administered for 86.0% of patients (50.4% with percutaneous coronary intervention [PCI] and 30.4% with thrombolytic treatment). The follow-up period was 350.62 person-years. In one year, 76 patients (18.5%) died, of whom 12.4% had PCI, 16.1% thrombolytic treatment, and 0.38% no reperfusion therapy. Independent predictors of mortality were: No reperfusion therapy (hazard ratio [HR]: 2.42, 95% CI, 1.14%, 5.11%) and glomerular filtration rate (HR:0.97, 95% CI, 0.94%, 0.99%). Conclusion In this study, the older patients with STEMI treated by PCI had a lower one-year mortality rate. It is recommended to establish a comprehensive STEMI network to enhance timely reperfusion for these patients and improve their health literacy.

INTRODUCTION: Hypertension is widely known as a significant factor in the development of cardiovascular diseases. However, there is increasing interest in the potential link between low admission systolic blood pressure (SBP) and higher mortality rates. Therefore, this study aimed to investigate the relationship between admission SBP and the probability of one-year mortality in patients with ST-segment elevation myocardial infarction (STEMI).METHOD: This study, which used data from registries, focused on patients diagnosed with STEMI between July 2018 and December 2019. The patients were divided into three groups based on their admission SBP: normal (< 112 mm Hg), elevated (112–140 mm Hg), and hypertension (≥140 mm Hg), and were followed for one year. The researchers used Cox proportional models to analyze the data, which allowed them to estimate crude and fully adjusted hazard ratios, along with their corresponding 95% confidence intervals (HR, 95% CI).RESULTS: This study, which included 1159 patients with a mean age of 60.71±12.19, 914 (78.86%) were male, and 108 (9.32%) died within one year. Among the patients, 276 had a normal admission SBP, 338 had elevated SBP, and 545 had hypertension. Those with hypertension had a higher-risk profile, including factors such as hyperlipidemia, BMI, LDL levels, anterior myocardial infarction, and a higher prevalence of females. The crude and fully adjusted hazard ratios (HR) for the relationship between elevated admission SBP and mortality were calculated as 0.36 (95% CI: 0.23-0.56) and 0.43 (95% CI: 0.23-0.81), respectively.CONCLUSION: The study's findings indicate a connection between increased admission SBP and a decreased probability of one-year mortality among patients with STEMI. Unlike the general population, where there is a direct linear correlation between SBP and the risk of future cardiovascular events, this research demonstrates an inverse relationship between SBP and one-year mortality.

Objectives Older diabetic patients with myocardial infarction (MI) are vulnerable group. This study aims to compare the prevalence of risk factors, type of reperfusion therapy, and mortality in diabetic and non-diabetic elderly with MI. Methods & Materials This is a cohort study. The statistical population consists of all older adults (age ≥60 years), whose information was available in the ST-segment elevation myocardial infarction (STEMI) registry system of Imam Ali hospital in Kermanshah, Iran from July 2016 to January 2020. Of these, 1460 participants with STEMI were selected based on the inclusion criteria and divided into two diabetic and non-diabetic groups. Their information was recorded by trained nurses using a checklist surveying demographic information, medical records, cardiovascular disease risk factors, clinical and diagnostic tests, type of treatment, and death at the time of admission, hospitalization and discharge. Data analysis was performed using descriptive statistics, independent t-test, Mann-Whitney and chi-square test in Stata software, version 14. P

Introduction: Studies have linked secondhand smoke (SHS) exposure to adverse health effects. The high prevalence of heart disease necessitates the need for studies in this field. Therefore, the aim of the present study was to assess the exposure to SHS in cardiac patients. Method: This study is a cross-sectional descriptive study. A total of 430 patients who were referred to Imam Ali Hospital in Kermanshah, Iran, in 2020 were included in the study based on predetermined inclusion and exclusion criteria. The researchers collected and recorded demographic information, disease history, and exposure to secondhand smoke (SHS) through a digital questionnaire. Bivariate analysis was conducted using a chi-square test and an independent T-test, depending on the variable scale. Results: The results of the study showed that 237 patients were male (55.12 %) and 193 were female (44.8 %). The prevalence of exposure to secondhand smoke was 72.09 %. Notably, the highest rate of exposure to secondhand smoke was associated with 'exposure to tobacco smoke in public places' with a rate of 69.30 %. Additionally, it was observed that approximately 39.07 % of patients reported exposure to secondhand smoke in public places at least once a week. Conclusion: The present study has found that cardiac patients frequently experience secondhand smoking exposure, with public settings being the primary location of exposure. Implementing intervention strategies and enacting laws that prohibit smoking can effectively mitigate the negative impact of SHS exposure.

Objectives The prevalence of cardiovascular risk factors is different in the elderly and middle-aged. Therefore the present study aims to compare the prevalence of risk factors affecting ST-elevation myocardial infarction (STEMI), type of treatment, and mortality rate in these two groups. Methods & Materials This retrospective cohort study included 1 071 elderly and middle-aged ST-elevation myocardial infarction (STEMI) patients who had referred to Kermanshah Imam Ali Hospital for 23 months from January 2017 to November 2019. Demographic information, cardiovascular risk factors, type of treatment, and mortality were examined. Data were analyzed with descriptive statistics, independent t test, and Chi-square test in Stata software version 14 with a significance level of 0.05. Results In the present study, the prevalence of risk factors, including smoking, high triglyceride, overweight, and obesity in the middle-aged group was significantly more than the elderly group (P < 0.05). The low-density lipoprotein (LDL) mean (mg/dL) in the middle-aged group (99.26 ± 71.69) was significantly higher than the elderly group (96.29 ± 8.5) (P < 0.05). The rate of primary angioplasty use was higher in the middle-aged (55.31%) than in the elderly (48.52%). Other results indicated that the overall mortality rate in the elderly (15.7%) was higher than in the middle-aged (4.4%) (P < 0.001). The prevalence of myocardial infarction, stroke, hypertension, hyperlipidemia, and glomerular filtration rate (GFR) < 60 was significantly higher in the elderly group compared to the middle-aged (P < 0.05). Conclusion The prevalence of low glomerular filtration rate (GFR), hyperlipidemia, and hypertension, myocardial infarction and stroke is higher in the elderly than in the middle-aged, while the prevalence of vital risk factors, such as smoking, triglycerides, overweight, and obesity in the middle-aged group is significantly higher than the elderly. If these risk factors are planned and controlled in middle age, people will be less at risk for myocardial infarction in aging.

Abstract Background and Aims Low‐ and middle‐income nations account for at least three‐quarters of cardiovascular disease deaths worldwide. This study aimed to obtain real knowledge about ST segment elevation myocardial infarction (STEMI) patients and provide the context for developing a principles for care quality improvement. Method This cross‐sectional study was conducted from July 2018 through December 2019. The study sample consisted of1169 eligible patients based on inclusion criteria. The data were collected using the standard EROP and three specialized, trained questionnaires. The collected data were checked by the quality control officer and analyzed using Stata Version 14. Results Patient baseline characteristics showed that body mass index, low‐density lipoprotein, high‐density lipoprotein, total cholesterol, and triglyceride levels were higher in women. Also, females recorded a considerable history of diabetes mellitus, hypertension, and hypercholesterolemia compared to men. The results also showed that most men were smokers (46.80%). Aspirin (94.27%), statins (91.48%), and clopidogrel (90.68%) were the common medications used at hospital discharge for patients. Conclusion The present study suggests that identifying and managing modifiable risk factors can improve cardiovascular disease outcomes. Also, considering the early identification of STEMI patients with new therapies can effectively decrease the rate of cardiovascular disease and its attributed health outcomes.

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