Myocardial infarction (MI) is the leading cause of death in Tunisia.

We wanted to determine the predictors of mortality in the wake of an IDM to ensure better care.

This is a study that included 1562patients (1221men and 341women) hospitalized for Acute Coronary Syndrome with ST segment elevation in the Fattouma Bourguiba Monastir Heart Hospital B ward from January 1998 to September 2015. The predictive factors for 1-month mortality of MI were studied.

The mortality rate was estimated at 8.3%. Sex was not a predictor of mortality (7.3% vs. 12%, P=0.055). The history of coronary artery disease or heart failure was not a predictor of death with p equal to 0.553 and 0.575, respectively. Age over 75, diabetes, hypertension, use of an inotropic agent at admission, the occurrence of a complete atrioventricular block, complicated MI of a severe rhythm disorder (ventricular tachycardia or ventricular fibrillation) and the occurrence of severe acute mitral insufficiency would be predictive of mortality with p respectively equal to 0.03; <0.001; 0.002; <0.001; <0, 001; <0.001; 0.001. The infarct territory was also a predictor of mortality: the death rate was 10.6% in the anterior MIs, 7.6% in the inferior MIs and 2.5% in the lateral MIs (P<0.001).

The advanced age, the diabetes, the HTA, the use of an inotropic agent at the admission, the occurrence of a serious rhythmic complication or of important acute mitral insufficiency and the anterior seat of the infarct are the predictors of mortality for 1-month of MI.