Risk Factors and Trends in Incidence of Heart Failure Following Acute Myocardial Infarction

Abstract Background/Introduction Previous studies have shown that poor nutritional status relate to the clinical outcomes in patients with heart failure (HF). However, relationships between initial serum albumin and newly developing HF after acute myocardial infarction (AMI) remain unclear. Methods We evaluated 2289 consecutive patients with AMI in our hospital. Primary outcome was HF hospitalization after AMI. We analyzed the predictive impact of initial serum albumin using multivariate analysis, both in all AMI patients and subgroup of AMI patient without known risk factors of HF (LMT, peak CK >8000, eGFR <30, and LVEF <35%). Result In the remote-phase(median follow-up: 754 days), 5.4% of all AMI patients were hospitalized due to HF. Multivariate analysis showed that low albumin (<4.0g/dl) was an independent predictor of HF hospitalization after AMI in all patients, as well as other known risk factors. Interestingly, low albumin still showed the predictive value even in the no-HF risk subgroup. Kaplan-meier curve of no-HF risk group is shown in the Figure. Conclusions Low initial albumin level would be an useful predictor of newly developing HF in the remote-phase after AMI. Figure 1 Funding Acknowledgement Type of funding source: None

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The effect of the presence of metabolic syndrome criteria on the post-infarction course in patients with acute myocardial infarction with ST-segment elevation

Ukrainian Journal of Cardiology ◽

10.31928/1608-635x-2020.3.6072 ◽

2020 ◽

Vol 27 (3) ◽

pp. 60-72

Author(s):

O. V. Shumakov ◽

O. M. Parkhomenko ◽

O. V. Dovhan ◽

O. S. Gurjeva

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Heart Failure ◽

Metabolic Syndrome ◽

Acute Myocardial Infarction ◽

Heart Rate ◽

Clinical Course ◽

Matching Criteria ◽

Group 1

The aim – to assess the additional prognostic information of metabolic syndrome (MS) components in groups of patients with acute myocardial infarction with segment elevation ST (STEMI), equalized in terms of commonly used acute coronary syndrome (ACS) risk factors. Materials and methods. Retrospective analysis of the 820 cases of STEMI included: evaluation of risk factors according to the scales TIMI, GRACE, PURSUIT, and evaluation of components of the metabolic syndrome at entry (the presence of diabetes mellitus and/or increasing glucose levels > 7 mmol/l, overweight, hypertension, dyslipidemia), as well as the assessment of the indicators of clinical course of hospital period of MI, treatment and results of follow-up of patients, including the information about cases of cardiac death. Results and discussion. Via automated «case-match-control» algorhythm from the basic cohort 2 groups were selected: group 1 (n=41, patients with MS) and group 2 (n=123, patients without MS). Matching criteria included following 13 risk factors: age, height, presence of heart failure, smoking, systemic hypotension at the 1 day of AMI, presence of anterior STEMI, the peak level of the MB-CK and AST, a history of angina and the period of unstable angina before STEMI, the presence of previous MI, baseline heart rate, baseline glomerular filtration rate (CKD-EPI), male gender. Groups were exactly matched by the first 4 matching criteria, and among other criteria maximum mismatch of 3 criteria was allowed (mean mismatch was 1.87 criteria from 13 per pair, and there were no significant differences in groups by each of 13 matching criteria). Otherwise, group 1 was characterized by more severe baseline profile, clinical course of hospital period, but it has the more intensive medical treatment also (including more frequent prescription of ACE inhibitors). According to the follow-up data, patients in group 1 had smaller end-systolic and end-diastolic indexes, more signed improvement in acute heart failure rate, higher heart rate variability and smaller dispersion of repolarisation at the 10th day. Also there was observed a trend toward a lower 3-year mortality (4,9 versus 17,1 %; p=0.05). Conclusions. The presence of MS accompanying STEMI is associated with poorer course of acute period of the disease and, in a contrary, with more favorable course of post-infarction period because of more intensive cardiac therapy in this group of patients.

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Risk Factors Associated with the Incidence of Ventricular Arrhythmias Complicating Acute Myocardial Infarction and Prognosis Analysis

Journal of Nanomaterials ◽

10.1155/2021/9985899 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Guibin Li ◽

Shengxin Liu ◽

Jiali Jin ◽

Kejun Ding ◽

Caizhen Qian

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Heart Failure ◽

Acute Myocardial Infarction ◽

Serum Potassium ◽

Ventricular Arrhythmias ◽

Endothelin 1 ◽

Factors Associated ◽

Tnf Α ◽

Independent Risk Factors

Ventricular arrhythmias (VTA) usually occur following acute myocardial infarction (AMI). However, risk factors for VTA attack after AMI have been not well-recognized. The purpose of the study is to identify risk factors associated with the incidence of VTA complicating AMI. A total of 200 patients with AMI who were admitted to our hospital from February 2018 to February 2020 were retrospectively analyzed. These 200 patients were classified into a non-VTA group ( n = 140 ) and a VTA group ( n = 60 ) based on the occurrence of VTA within 24 after AMI. Patients in the VTA group were older than those in the non-VTA group. The VTA group had more numbers of WBCs and neutrophils than the non-VTA group. The level of serum potassium was lower, but the levels of cTnT and CK-MB were higher in the VTA group than in the non-VTA group. The VTA group presented an increase in proportions of anterior MI, TpTe, and proportions of Killip classification ≥ class II but a decline in LVEF when comparable to the non-VTA group. The two groups were not significantly different concerning other variables including sex, tobacco use, alcohol consumption, diabetes mellitus, hypertension, heart rate, Scr, SUA, BUN, PTL counts, TC, TG, HDL-C, LDL-C, D-dimer, BNP, LVS, LVP, and LVEDd. The levels of hsCRP, endothelin-1, and TNF-α were remarkably higher in the VTA group than in the non-VTA group ( P < 0.001 ). Multivariate logistic regression analysis was performed, with clinical variables including age, WBCs, neutrophils, serum potassium, cTnT, CK-MB, hsCRP, endothelin-1, TNF-α, anterior MI, TpTe, proportions of Killip classification ≥ class II, and LVEF as an independent variable and with the occurrence of VTA as a dependent variable. It was revealed that serum potassium, cTnT, CK-MB, hsCRP, endothelin-1, TpTe, proportions of Killip classification ≥ class II, and LVEF were independent risk factors of VTA complicating AMI. Compared with the non-VTA group, the incidence rate of simple left heart failure, total heart failure, stroke, and dyslipidemia in the VTA group was significantly higher than those in the non-VTA group ( P < 0.05 ). It was found that the proportion of all-cause deaths within one year outside the hospital was higher in the VAT group than in the non-VAT group ( P < 0.05 ). Collectively, the study demonstrates serum potassium, cTnT, CK-MB, hsCRP, endothelin-1, TpTe, proportions of Killip classification ≥ class II, and LVEF were independent risk factors of VTA complicating AMI.

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