2023, Number 1
Prognostic factors for complications and extent of acute myocardial infarction
Language: Spanish
References: 50
Page: 11-21
PDF size: 392.06 Kb.
ABSTRACT
Introduction: Cardiovascular diseases are the leading cause of morbidity, mortality and disability worldwide. One of the most frequent acute manifestations of ischemic heart disease is acute myocardial infarction (AMI).Objective: To determine the factors influencing the evolution of patient with acute myocardial infarction.
Method: Prospective cohort study carried out in the department of cardiology of the Hospital Clínico Quirúrgico Hermanos Ameijeiras, from March 2019 to March 2021. Ninety-five patients with a diagnosis of acute myocardial infarction were treated evaluated.
Results: Males predominated with 67.4% and mean age was 63.0±11.5 years old. Mean body mass index was 27±3.8, high blood pressure was present in 71.6% and non-ST segment elevation myocardial infraction in 54.7%. Percutaneous coronary intervention was performed in 85.3% of patients, fibrinolysis was used in 12.6% and coronary surgery only in 2.1%. Atrial fibrillation was the most common complica-tion, present in a 10.5% of cases. The peak troponin value was independently asso-ciated with the presence of complications (p=0.039, OR 1.001 [1.000-1.001]). The var-iables that remained independently associated with greater extent of the infarction were male gender (p=0.048, OR 0.369 [0.137-0.990]) and type of AMI (p=0.016. OR 3.972 [1.288-12.248]).
Conclusions: The probability of presenting complications after a myocardial infarc-tion is independently influenced by the highest troponin value. Greater extent of acute myocardial infarction was associated with males and the ST-segment elevation myocardial infraction.
REFERENCES
Ciruzzi M, Pramparo P, Rozlosnik J, Zylberstjn H, Delmonte H, Haquim M, et al. Hypertension and the risk of acute myocardial infarction in Argentina. The Argentine Factores de Riesgo Coronario en America del Sur (FRICAS) Investigators. Prev Cardiol. 2001;4(2):57-64. DOI: https://doi.org/10.1111/j.1520-037x.2001.00526.x
Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2018;39(2):119-77. DOI: https://doi.org/10.1093/eurheartj/ehx393
Padilla-Cueto DI, Hernández-Negrín H, Pérez-Valdivia A, Barrreto-Fiu E, Ramírez-Gómez JI. Factores pronósticos de mortalidad intrahospitalaria en pacientes con infarto agudo del miocardio con elevación del segmento ST. Hospital Arnaldo Milián Castro. Villa Clara, Cuba. 2015. Med UIS. 2017;30(3):67-74. DOI: https://doi.org/10.18273/revmed.v30n3-2017007
Strebel I, Twerenbold R, Wussler D, Boeddinghaus J, Nestelberger T, du Fay de Lavallaz J, et al. Incremental diagnostic and prognostic value of the QRS-T angle, a 12-lead ECG marker quantifying heterogeneity of depolarization and repolarization, in patients with suspected non-ST-elevation myocardial infarction. Int J Cardiol. 2019;277:8-15. DOI: https://doi.org/10.1016/j.ijcard.2018.09.040
León-Aliz E, Moreno-Martínez FL, Pérez-Fernández GA, Vega-Fleites LF, Rabassa-López-Calleja MA. Índice leuco-glucémico como marcador pronóstico de la evolución intrahospitalaria en pacientes con infarto agudo de miocardio con elevación del ST. Clin Investig Arterioscler. 2014;26(4):168-75. DOI: https://doi.org/10.1016/j.arteri.2014.01.002
Novo Choy LE, Gómez García YC, Milord Fernández Y, Ramos González HL. Caracterización de pacientes con infarto miocárdico con elevación del ST complicados no trombolizados. Acta Méd Centro [Internet]. 2014 [citado 24 Abr 2022];8(1):29-36. Disponible en: https://revactamedicacentro.sld.cu/index.php/amc/article/view/42/51
Díaz Benítez RE, Correa Morales AM, Reyes Hernández LM, Carvajal Sánchez PA, Coronado Herrera Y, González Rivera EM. Hemoglobina glucosilada e índice leucoglucémico como determinaciones pronósticas en el síndrome coronario agudo. CorSalud [Internet]. 2016 [citado 28 Abr 2022];8(3):153-63. Disponible en: https://revcorsalud.sld.cu/index.php/cors/article/view/135/321
McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). With the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2022;24(1):4-131. DOI: https://doi.org/10.1002/ejhf.2333
Bradley SM, Spertus JA, Kennedy KF, Nallamothu BK, Chan PS, Patel MR, et al. Patient selection for diagnostic coronary angiography and hospital-level percutaneous coronary intervention appropriateness: insights from the National Cardiovascular Data Registry. JAMA Intern Med. 2014;174(10):1630-9. DOI: https://doi.org/10.1001/jamainternmed.2014.3904
Arroyo-Rodríguez C, Brito-Zurita OR, Sandoval-Navarrete S, Solis-Vásquez R, Ornelas-Aguirre JM, Olea-Hernández C, Vásquez-Serna C, Castelan-Ojeda AM. Factores de riesgo para la enfermedad arterial coronaria de tres vasos en pacientes del noroeste de México. Arch Cardiol Mex. 2018;88(5):423-31. DOI: https://doi.org/10.1016/j.acmx.2018.02.009
Rojas-Velázquez JM, de la Torre Fonseca LM, Giralt-Herrera A, Machín-Legón M, Leiva-Enríquez J. Complicaciones no letales en el infarto agudo de miocardio: Análisis en una unidad de cuidados coronarios. CorSalud [Internet]. 2019 [citado 28 Abr 2022];11(2):113-9. Disponible en: https://revcorsalud.sld.cu/index.php/cors/article/view/408/863
Ladeiras-Lopes R, Sampaio F, Bettencourt N, Fontes-Carvalho R, Ferreira N, Leite-Moreira A, Gama V. El cociente entre la grasa abdominal visceral y la subcutánea evaluado por tomografía computarizada es un predictor independiente de mortalidad y eventos cardiacos. Rev Esp Cardiol. 2017;70(5):331-7. DOI: https://doi.org/10.1016/j.recesp.2016.09.006
Puymirat E, Simon T, Cayla G, Cottin Y, Elbaz M, Coste P, et al. Acute Myocardial Infarction: Changes in Patient Characteristics, Management, and 6-Month Outcomes Over a Period of 20 Years in the FAST-MI Program (French Registry of Acute ST-Elevation or Non-ST-Elevation Myocardial Infarction) 1995 to 2015. Circulation. 2017;136(20):1908-19. DOI: https://doi.org/10.1161/circulationaha.117.030798
Castro-Romanoshky ME, Paumier-Galano E, Abad-Loyola PL, Torres-Ferrand R, Navarro-Navarro V. Caracterización de pacientes con infarto agudo del miocardio con elevación del segmento ST, Baracoa, Guantánamo 2017-2019. Rev Inf Cient [Internet]. 2020 [citado 3 May 2022];99(4):310-320. Disponible en: https://revinfcientifica.sld.cu/index.php/ric/article/view/2984
Kappetein AP, Head SJ, Morice MC, Banning AP, Serruys PW, Mohr FW, et al. Treatment of complex coronary artery disease in patients with diabetes: 5-year results comparing outcomes of bypass surgery and percutaneous coronary intervention in the SYNTAX trial. Eur J Cardiothorac Surg. 2013;43(5):1006-13. DOI: https://doi.org/10.1093/ejcts/ezt017
Santos Medina M, Barreiro García A, García González RC, Barreiro Noa AE. Factores de riesgo de mortalidad hospitalaria post infarto agudo de miocardio. Rev Cuban Cardiol [Internet]. 2017 [citado 8 May 2022];23(3). Disponible en: https://revcardiologia.sld.cu/index.php/revcardiologia/article/view/710/pdf_91
Ortega Palomino ME, Orellana Marín FJ. Factores predictivos de mortalidad intrahospitalaria en infarto agudo de miocardio con elevación del segmento ST, estudio realizado en el Hospital de Especialidades Teodoro Maldonado Carbo durante el período 2013-2017 [Tesis]. Guayaquil (Ecuador): Universidad de Guayaquil [Internet]; 2018 [citado 8 May 2022]. Disponible en: http://repositorio.ug.edu.ec/handle/redug/31114
Morrow DA, Antman EM, Charlesworth A, Cairns R, Murphy SA, de Lemos JA, et al. TIMI risk score for ST-elevation myocardial infarction: A convenient, bedside, clinical score for risk assessment at presentation: An intravenous nPA for treatment of infarcting myocardium early II trial substudy. Circulation. 2000;102(17):2031-7. DOI: https://doi.org/10.1161/01.cir.102.17.2031
Montisci R, Ruscazio M, Tona F, Corbetti F, Sarais C, Marchetti MF, et al. Coronary flow reserve is related to the extension and transmurality of myocardial necrosis and predicts functional recovery after acute myocardial infarction. Echocardiography. 2019;36(5):844-53. DOI: https://doi.org/10.1111/echo.14337