scholarly journals Short‐ and Long‐Term Clinical Outcomes for Patients With Takotsubo Syndrome and Patients With Myocardial Infarction: A Report From the Swedish Coronary Angiography and Angioplasty Registry

2021 ◽  
Vol 10 (17) ◽  
Author(s):  
Björn Redfors ◽  
Sandeep Jha ◽  
Sigurdur Thorleifsson ◽  
Tomas Jernberg ◽  
Oskar Angerås ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Coronary Angiography ◽  
Cardiogenic Shock ◽  
Acute Heart Failure ◽  
Mortality Risk ◽  
Takotsubo Syndrome ◽  
Killip Class ◽  
St Segment Elevation ◽  
Similar Risk

Background Takotsubo syndrome (TS) is a potentially life‐threatening acute cardiac syndrome with a clinical presentation similar to myocardial infarction and for which the natural history, management, and outcome remain incompletely understood. Our aim was to assess the relative short‐term mortality risk of TS, ST‐segment–elevation myocardial infarction (STEMI), and non‐STEMI (NSTEMI) and to identify predictors of in‐hospital complications and poor prognosis in patients with TS. Methods and Results This is an observational cohort study based on the data from the SCAAR (Swedish Coronary Angiography and Angioplasty Registry). We included all patients (n=117 720) who underwent coronary angiography in Sweden attributed to TS (N=2898 [2.5%]), STEMI (N=48 493 [41.2%]), or NSTEMI (N=66 329 [56.3%]) between January 2009 and February 2018. We compared patients with TS to those with NSTEMI or STEMI. The primary end point was all‐cause mortality at 30 days. Secondary outcomes were acute heart failure (Killip Class ≥2) and cardiogenic shock (Killip Class 4) at the time of angiography. Patients with TS were more often women compared with patients with STEMI or NSTEMI. TS was associated with unadjusted and adjusted 30‐day mortality risks lower than STEMI (adjusted hazard ratio [adjHR], 0.60; 95% CI, 0.48–0.76; P <0.001), but higher than NSTEMI (adjHR, 2.70; 95% CI, 2.14–3.41; P <0.001). Compared with STEMI, TS was associated with a similar risk of acute heart failure (adjHR, 1.26; 95% CI, 0.91–1.76; P =0.16) but a lower risk of cardiogenic shock (adjHR, 0.55; 95% CI, 0.34–0.89; P =0.02). The relative 30‐day mortality risk for TS versus STEMI and NSTEMI was higher for smokers than nonsmokers (adjusted P interaction STEMI=0.01 and P interaction NSTEMI=0.01). Conclusions The 30‐day mortality rate in TS was higher than in NSTEMI but lower than STEMI despite a similar risk of acute heart failure in TS and STEMI. Among patients with TS, smoking was an independent predictor of mortality.

scholarly journals Acute heart failure following myocardial infarction: complement activation correlates with the severity of heart failure in patients developing cardiogenic shock

2018 ◽  
Vol 5 (3) ◽  
pp. 292-301 ◽  
Author(s):  
Hilde L. Orrem ◽  
Per H. Nilsson ◽  
Søren E. Pischke ◽  
Guro Grindheim ◽  
Peter Garred ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Cardiogenic Shock ◽  
Acute Heart Failure ◽  
Complement Activation

scholarly journals Predictors of acute heart failure in patients with ST-segment elevation myocardial infarction of the electrocardiogram after PCI

Kardiologiia ◽  
2018 ◽  
Vol 17 (S8) ◽  
pp. 20-28
Author(s):  
E. M. Mezhonov ◽  
◽  
Y. A. Vyalkina ◽  
K. A. Vakulchik ◽  
S. V. SHalaev ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Heart Failure ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

scholarly journals The Utility of New Biomarker-based Predictive Model for Clinical Outcomes Among ST-elevation Myocardial Infarction Patients

2020 ◽  
Vol 10 (1) ◽  
pp. 23-37
Author(s):  
Olga V. Petyunina ◽  
Mykola P. Kopytsya ◽  
Alexander E. Berezin
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Predictive Model ◽  
Clinical Outcomes ◽  
Coronary Intervention ◽  
Complete Revascularization ◽  
Discriminative Ability ◽  
Killip Class ◽  
St Segment Elevation ◽  
Acute Stemi

Aim: To determine the discriminative potency of score to prognosticate poor clinical outcomes in ST-Segment Elevation Myocardial Infarction (STEMI) patients. Methods: From the entire population of STEMI (n=268), we enrolled 177 individuals with acute STEMI who underwent complete revascularization with primary Percutaneous Coronary Intervention (PCI). Clinical assessment, echocardiography, Doppler, and biomarkers’ measure were performed at baseline. Results: Combined endpoint (Major Cardiovascular Events - MACEs [composite of cardiovascular death, recurrent myocardial infarction, newly diagnosed Heart Failure] and hospitalization) was determined in 75 patients with acute STEMI population (40.6%). Newly onset heart failure (HF) was reported in 46 patients (26.0%), Cardiovascular (CV) death occurred in 12 patients (6.8%), MACEs were determined in 58 patients (32.8%), and recurrent hospitalization due to CV reasons was found in 17 (9.6%). The conventional risk predictive models were engineered by a combination of TIMI risk score +acute HF Killip class ≥ II + the levels of NT-pro brain natriuretic peptide > 300 pg / mL and troponin >0.05 ng/mL. We developed a new predictive model based on the presentation of T786С genotype of endothelial NO syntase gene (rs 2070744), А1166С in angiotensin-ІІ receptor-1 gene (rs5186) and serum levels of soluble suppressor tumorigenicity ≥35 pg/mL, vascular endothelial growth factor ≤172 pg/mL and macrophage inhibitory factor ≥2792.7 pg/mL. STEMI patients who had >5 score points demonstrated significantly worse prognosis than those who had ≤5 score points. Conclusion: Here we have reported that a new original predictive model is better than a conventional model in discriminative ability to predict combined clinical outcome in STEMI patients.

Impact of Clinical Profile on Hospital Mortality in Patients with Acute Heart Failure and Acute Myocardial Infarction with ST-Segment Elevation

2014 ◽  
Vol 20 (8) ◽  
pp. S117
Author(s):  
Ricardo Mourilhe-Rocha ◽  
Marcelo L.S. Bandeira ◽  
Nathalia F. Araujo ◽  
Ana Rafaela M. Santos ◽  
Roberta Ribeiro ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Hospital Mortality ◽  
Acute Heart Failure ◽  
Clinical Profile ◽  
St Segment Elevation ◽  
St Segment

scholarly journals Comparison of in Hospital Outcome of Patients with and without Distorted Terminal Portion of QRS Complex on Initial Electrocardiogram in ST Segment Elevation Myocardial Infarction

2016 ◽  
Vol 11 (1) ◽  
pp. 30-35
Author(s):  
Khandaker Aisha Siddika ◽  
Md Abu Siddique ◽  
Shamim Ahsan ◽  
Arif Hossain ◽  
Sohel Mahmud ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Hospital Mortality ◽  
Cardiogenic Shock ◽  
P Value ◽  
Qrs Complex ◽  
Terminal Portion ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

Background: Distorted terminal portion of QRS complex on initial electrocardiogram in ST segment elevation myocardial infarction is a strong predictor of inhospital adverse outcome.Objectives: Our purpose of this study was to analyse admission ECG in patients of STEMI based on terminal portion of QRS complex and find out inhospital death, heart failure, cardiogenic shock and recurrent MI.Methods: We evaluated 60 patients of STEMI admitted within 12 hours and receiving thrombolytic therapy. We defined two ECG groups according to absence of distortion of terminal QRS (Group-I) and presence of distorted terminal QRS (Group-II) in two or more adjacent leads. Group-II further divided into pattern-A – J point originating at ?50% of height of R wave in leads with qR configuration and pattern B- S wave is absent in leads with RS configuration.Results: Out of 60 patients of STEMI, 30(50.0%) patients had distortion of QRS. There were 7(11.6%) deaths, 16(26.7%) heart failure, 3(5.0%) cardigenic shock and no recurrent myocardial infarction. Hospital mortality and heart failure were found to be significantly higher in distorted QRS group (3.3% vs. 20.0%, p=0.04; 13.3% vs. 40.0%, p=0.02; respectively), cardiogenic shock of both groups did not show significant difference (0.0% vs. 10.0%, p=0.075). Multiple logistic regression analysis using hospital mortality as dependable variable and all studied risk factors were independent variables, QRS distortion on admission ECG and Killip class were only variable found to be statistically significant (OR=7.25, p value < 0.05 ; OR=16.25, p value < 0.05 respectively).Conclusion: Careful analysis of ECG which is simple, cheap, universally available bed side investigation may offer important prognostic information in patients with STEMI and would help in deciding which patients should go urgent myocardial revascularization procedure.University Heart Journal Vol. 11, No. 1, January 2015; 30-35

scholarly journals Serum Copeptin as the Predictor for Acute Heart Failure Complication of Acute Myocardial Infarction in Patients with ST-Segment Elevation

2020 ◽  
Vol 26 (3) ◽  
Author(s):  
Ardi Putranto Ari Supomo ◽  
JB. Suparyatmo ◽  
Dian Ariningrum
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Multivariate Analysis ◽  
Acute Heart Failure ◽  
Cardiac Event ◽  
St Segment Elevation ◽  
Copeptin Level ◽  
St Segment ◽  
Increased Risk

Acute Myocardial Infarction (AMI) is necrotic cardiac muscle cells due to unstable ischemic syndrome. Therapy monitoring is needed because various complications may occur (Heart Failure/HF). ST-Segment Elevation Myocardial Infarction (STEMI) can develop to Acute Heart Failure (AHF) due to myocardial dysfunction, transmural heart disease, pathological cardiac remodeling. Copeptin is an antidiuretic hormone which increases in the cardiac event. It can be used as a predictor of a further cardiac event. This study aimed to determine the role of serum copeptin level as a predictor of AHF complication in STEMI patients. A prospective cohort study was performed in 85 adult STEMI patients admitted to The Clinical Pathology Installation of Dr. Moewardi Hospital, Surakarta. Data with normal and abnormal distribution were presented in mean±Standard Deviation (SD) and median (min-max), respectively. Statistical analysis was performed using Kolmogorov-Smirnov, bivariate, and multivariate analysis for RR with Confidence Interval (CI) of 95% and p < 0.05 was considered significant. The copeptin cut-off point was determined using the ROC curve. Bivariate and multivariate analysis showed a higher copeptin level in STEMI patients with AHF compared to that of non-AHF (RR=5.172, CI 95% 1.795-14.902, p=0.002 and RR=1.889, CI 95% 1.156-3.086, p=0.001; respectively). The STEMI patients with an elevated level of copeptin showed an increased risk of AHF (STEMI with elevated copeptin level vs STEMI with normal copeptin level; 28.74% vs. 88.91%). Copeptin level is significantly related to AHF complication in STEMI patient, the higher level of copeptin led to the higher the risk of AHF.

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