Prognosis

Prognosis for patients with STEMI varies depending on time to presentation after onset of chest pain and time to treatment after presentation. In-hospital mortality from STEMI is around 9%.[209][210]​​ Prognosis is improved by early reperfusion, adherence to appropriate medical therapy, and risk factor modification. Patients with elevated troponin levels have a worse prognosis than those with normal troponin levels.[79]​​[80]

​Participation in cardiac rehabilitation reduces all-cause mortality and readmissions for cardiac reasons.[5]​[211] Nonfatal health outcomes (including development of heart failure, atrial fibrillation, cerebrovascular disease, peripheral arterial disease, severe bleeding, renal failure, diabetes mellitus, dementia, depression, and cancer) and all-cause mortality are higher in patients that have had an myocardial infarction, than in patients that have not.[212]​​ Adherence to evidence-based medicine has been shown to have better patient outcomes.[213][214] Major bleeding as defined by the Bleeding Academic Research Consortium (BARC) or the Thrombolysis in Myocardial Infarction (TIMI) bleeding score is associated with worse 1-year mortality.[215]​ Specific risk models to predict mortality following acute coronary syndrome in older adults have been developed, including variables such as hearing impairment, mobility impairment, weight loss, and patient-reported health status.[216]

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