Predictors and prognosis of spontaneous reperfusion in acute myocardial infarction - 17/04/19
Résumé |
Background |
ST elevation myocardial infarction (STEMI) remains one of the most frequent emergencies, requiring an as early as possible reperfusion that may result, in some cases, from physiological fibrinolysis.
Objective |
We aimed to analyze the clinical characteristics of patients presenting with clinical markers of spontaneous reperfusion (SR) during acute myocardial infarction, and to evaluate its effect on hospital prognosis.
Methods |
We retrospectively reviewed data for 1785 patients admitted for STEMI. The patients were divided into SR group (spontaneous relief of chest pain less than 5 on a scale from 0 to 10, and ST segment elevation resolution of more than 50% from baseline) and non-SR group (the remaining population). The clinical and prognostic features of the patients were analyzed.
Results |
The incidence of SR in our population was 10.4% of patients (N=187). SR patients were younger (57.6 vs. 61.1 years; P=0.002) and had a higher prevalence of current smoking (77.9% vs. 65.9%; P=0.003) and less myocardial damage as indicated by lower peak creatine kinase (1158 vs. 2022 UI/l; P<0.001).
In hospital mortality (3.2% vs. 10%; P=0.013), heart failure (8.4% vs. 19.7%; P=0.001), atrial fibrillation (0.6% vs. 7.3%; P=0.002) and acute pericarditis (0% vs. 4%; P=0.011) were significantly lower for SR patients.
Multivariate analysis found smoking as the only predictor factor of SR (OR=1.82, 95% CI [1.2–2.7]; P=0.003).
Conclusion |
Our data shows that SR decreased infarction size, improved heart function and reduced mortality. The subgroup of STEMI with SR carries a more favorable prognosis.
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Vol 11 - N° 1P2
P. e285-e286 - avril 2019 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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