Morbidity, clinical features and prognosis of serious infection after acute myocardial infarction

Objective To investigate the morbidity,chinical features and prognosis of serious infections after acute myocardial infarction(AMI).Methods The clinical data of 220 patients with ST segment elevation myocardial infarction admitted in our department,from May 2010 to September 2012,were analyzed.Detailed informations about infection were collected for all patients.The characteristics of infection and details of infection was described.Cox proportional hazards models were used to assess 90-day outcomes among patients with and without infections after adjusting for associated clinical variables and with infection as a time-dependent covariate.Results Overall,53 patients(24％) developed a serious infection,most of whom presented with a single-site infection.The median (25th,75th percentile) time until diagnosis of infection was 3 (1,6) days.The most commonly identified organism was Staphylococcus aureus,and the main location of infection was the blood.These patients had more complications and lower procedural success at index percutaneous coronary intervention than those without infections.Serious infection was correlated with significantly higher rates of 90-day death(adjusted hazard ratio:5.6 ; 95％ confidence interval:3.8 to 8.4),death' rate of MI (adjusted hazard ratio:4.9 ; 95％ confidence interval:3.4 to 7.1).Conclusions Infections complicating the course of patients with STEMI are uncommon but markedly correlated with worse 90-day clinical outcomes.Mechanisms for early identification of these high-risk patients as well as design of strategies to reduce their risk of infection are warranted. Key words: Infection;  Percutaneous coronary intervention;  Acute myocardial infarction