scholarly journals Prognostic importance of dispersion of interval Q-T electrocardiograms in patients with myocardial infarction

2006 ◽  
Vol 5 (1) ◽  
pp. 91-96
Author(s):  
A. T. Teplyakov ◽  
D. Yu. Kamaev ◽  
V. V. Kalyuzhin ◽  
Ye. Yu. Pushnikova ◽  
Ye. V. Kalyuzhina ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Retrospective Analysis ◽  
Cardiac Rhythm ◽  
Independent Predictor ◽  
Heart Ventricles ◽  
Prognostic Importance

The aim of research was comparison of prognostic importance of various indexs non-homogeneousness of processes repolari-zations of heart ventricles registered in acute and subacute periods of myocardial infarction (MI). The retrospective analysis of med-ical histories has allowed to determine dynamics of dispersion of intervals Q-T, Q-Ta and R-Tm in groups of patients with fa-vourable (n = 125) and lethal (n = 250) outcome. The best prognostic importance concerning fatal cardial events have indexs cor-rected on frequency of cardiac rhythm. Most important and independent predictor of intrahospital cardial deaths of the patients with MI is a dispersion of the corrected interval R-Tm, exceeding 80 мс1/2 in the first 6 hours after hospitalization.

PROGNOSTIC IMPORTANCE OF HYPONATREMIA IN ACUTE STELEVATION MYOCARDIAL INFARCTION

2021 ◽  
pp. 53-55
Author(s):  
Datti Spandana ◽  
Pamidi Kavya Siva Keerthana ◽  
T. Murali Venkateswara Rao
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Early Development ◽  
Independent Predictor ◽  
St Elevation Myocardial Infarction ◽  
Plasma Sodium ◽  
Medical College ◽  
Patients At Risk ◽  
St Elevation ◽  
Prognostic Importance

Background: Hyponatremia has been shown to be a predictor of cardiovascular mortality among patients with heart failure. In fact, the neurohormonal activation that accompanies acute myocardial infarction is similar to that which accompanies heart failure. Aims And Objectives : To nd out the prognostic importance of hyponatremia in acute ST elevation myocardial infarction. Material And Methods: 100 consecutive patients presenting with acute ST-elevation myocardial infarction admitted to N.R.I Medical college and General hospital from March 2019 to March 2020 were studied. Qualifying patients underwent detailed history and clinical examination. Plasma sodium concentrations were obtained on admission and at 24, 48 and 72 hours thereafter. The primary end point was all cause mortality within 30 days following myocardial infarction. Results: In our study, substantial proportion of patients who presented with acute ST elevation myocardial infarction were hyponatremic on admission or developed hyponatremia shortly after admission. The odd's ratio for 30-day mortality was found to be high in the hyponatremic groups compared to normal group. We also found a signicant linear relationship between severity of hyponatremia and mortality. Multivariate analysis was performed which identied hyponatremia on admission or early development of hyponatremia as a signicant independent predictor of 30 day mortality. Conclusion: In our study we concluded that hyponatremia on admission or early development of hyponatremia in patients with acute ST elevation myocardial infarction is an independent predictor of 30-day mortality. Plasma sodium levels may serve as a simple marker to identify patients at risk.

scholarly journals Effects of reperfusion on late potentials of the QRS complex in acute myocardial infarction

2006 ◽  
Vol 59 (7-8) ◽  
pp. 369-373
Author(s):  
Radomir Matunovic ◽  
Zoran Cosic ◽  
Dragan Tavciovski ◽  
Radoslav Romanovic
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Rhythm ◽  
Diagnostic Method ◽  
Independent Predictor ◽  
Reperfusion Therapy ◽  
Late Potentials ◽  
Qrs Complex ◽  
Non Invasive ◽  
Infarct Related Artery

Introduction. Cardiac rhythm disorders are common in patients after myocardial infarction. They play an important role in the course and in prognosis of this illness. Signal-averaged electrocardiogram (SAECGj is a non-invasive diagnostic method for the induction of sustained monomorphic ventricular tachycardia. Early opening of the infarct-related artery decreases occurrence of ventricular disorders in these patients. The aim of this study was to establish the connection between the late potentials of the ORS complex (SAECG) and unsuccessful reperfusion in patients with acute myocardial infarction (AMI). Material and methods. After myocardial infarction, presence of SAECG was examined in patients receiving reperfusion therapy in order to establish the treatment outcome. Late potentials in SAECG were determined by computer measurements in regard to criteria for its positivity. Results. The study group consisted of 33 patients. Out of 23 patients with successful reperfusion, only 6 (26.1%) had late potentials, in contrast to the group without reperfusion, 8 (80%) out of 10 patients had late potentials. Conclusion. Based on our results, we can conclude that there is a significant association between the presence of late ORS-complex potentials (SAECG) and unsuccessful reperfusion. Also, we can conclude that presence of late potentials is an independent predictor of infarct-related artery patency in patients with AMI treated with thrombolytic therapy. .

Early-Term Complications after Carotid Endarterectomy and Their Risk Factors: Eight-Year Employment of Local Treatment Protocol of a Russian High-Volume Center

2020 ◽  
pp. 1-12
Author(s):  
Denis Skrypnik ◽  
Roman Vinogradov ◽  
Coral Falco ◽  
Alexander Baryshev ◽  
Vladimir Porhanov
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Myocardial Infarction ◽  
Carotid Endarterectomy ◽  
Retrospective Analysis ◽  
Independent Predictor ◽  
Univariate Analysis ◽  
Local Treatment ◽  
Data Set ◽  
History Of

<b><i>Background:</i></b> More than 20,000 carotid endarterectomies are performed annually in the Russian Federation. Until now, no studies based on the national carotid data set have been published. The objectives of this study were to evaluate early outcomes after carotid endarterectomy and to identify potential risk factors for major adverse cardiovascular events. <b><i>Materials and Methods:</i></b> The retrospective analysis was based on data recorded in a single-center registry, including all carotid endarterectomies performed between 2010 and 2017. A univariate analysis was used to identify the risk factors for perioperative mortality, and predictors of stroke were determined using a multivariate logistic regression model. <b><i>Results:</i></b> Data from 1,832 patients with a mean age of 64.1 ± 7.6 years were analyzed. The combined in-hospital mortality was 0.65% (12/1,832). The rate of stroke was 0.7% (13/1,832), and the rate of myocardial infarction was 1.1% (20/1,832). The 30-day stroke-free survival was 99%. A history of stroke (<i>p</i> = 0.02) and chronic obstructive pulmonary disease (COPD; <i>p</i> = 0.0001) were found to be predictive of a lethal stroke. Previous myocardial infarction (<i>p</i> = 0.0001), an advanced stage of congestive heart failure (<i>p</i> = 0.0001), and angina pectoris (<i>p</i> = 0.01) were associated with cardiac-related mortality. Moreover, diabetes mellitus (<i>p</i> = 0.03), COPD (<i>p</i> = 0.0001), and carotid calcinosis (<i>p</i> = 0.006) increased the risk of poor survival due to myocardial infarction. The mean duration of clamping was found to be an independent predictor of any perioperative stroke (OR = 1.109; 95% CI 1.052–1.129; <i>p</i> &#x3c; 0.0001). <b><i>Conclusions:</i></b> The present retrospective analysis of the local carotid surgery register showed appropriate outcomes after CEA regarding the cumulative incidence of MACE, which is comparable to previously published international register data. A previous history of stroke, myocardial infarction, COPD, a prolonged clamping time during CEA, and diabetes mellitus were found to be factors of high-risk for cardiovascular mortality. A prolonged clamping was identified as an independent predictor of any stroke.

scholarly journals Cardiac magnetic resonance derived global longitudinal strain outperfoms established functional parameters in prognostication after ST-elevation myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Holzknecht ◽  
M Reindl ◽  
C Tiller ◽  
I Lechner ◽  
T Hornung ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Prognostic Value ◽  
Longitudinal Strain ◽  
Independent Predictor ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Lv Function ◽  
St Elevation

Abstract Background Left ventricular ejection fraction (LVEF) is the parameter of choice for left ventricular (LV) function assessment and risk stratification of patients with ST-elevation myocardial infarction (STEMI); however, its prognostic value is limited. Other measures of LV function such as global longitudinal strain (GLS) and mitral annular plane systolic excursion (MAPSE) might provide additional prognostic information post-STEMI. However, comprehensive investigations comparing these parameters in terms of prediction of hard clinical events following STEMI are lacking so far. Purpose We aimed to investigate the comparative prognostic value of LVEF, MAPSE and GLS by cardiac magnetic resonance (CMR) imaging in the acute stage post-STEMI for the occurrence of major adverse cardiac events (MACE). Methods This observational study included 407 consecutive acute STEMI patients treated with primary percutaneous coronary intervention (PCI). Comprehensive CMR investigations were performed 3 [interquartile range (IQR): 2–4] days after PCI to determine LVEF, GLS and MAPSE as well as myocardial infarct characteristics. Primary endpoint was the occurrence of MACE defined as composite of death, re-infarction and congestive heart failure. Results During a follow-up of 21 [IQR: 12–50] months, 40 (10%) patients experienced MACE. LVEF (p=0.005), MAPSE (p=0.001) and GLS (p&lt;0.001) were significantly related to MACE. GLS showed the highest prognostic value with an area under the curve (AUC) of 0.71 (95% CI 0.63–0.79; p&lt;0.001) compared to MAPSE (AUC: 0.67, 95% CI 0.58–0.75; p=0.001) and LVEF (AUC: 0.64, 95% CI 0.54–0.73; p=0.005). After multivariable analysis, GLS emerged as sole independent predictor of MACE (HR: 1.22, 95% CI 1.11–1.35; p&lt;0.001). Of note, GLS remained associated with MACE (p&lt;0.001) even after adjustment for infarct size and microvascular obstruction. Conclusion CMR-derived GLS emerged as strong and independent predictor of MACE after acute STEMI with additive prognostic validity to LVEF and parameters of myocardial damage. Funding Acknowledgement Type of funding source: None

Prognostic impact of SYNTAX II score in patients with cardiogenic shock complicating ST-elevation myocardial infarction: analysis of an 10-year all-comers registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Juskova ◽  
P Tasende Rey ◽  
B Cid Alvarez ◽  
B Alvarez Alvarez ◽  
J.M Garcia Acuna ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiogenic Shock ◽  
Independent Predictor ◽  
Coronary Intervention ◽  
Prognostic Impact ◽  
Cardiac Events ◽  
Prognostic Information ◽  
St Segment Elevation ◽  
All Cause Mortality

Abstract Background The SYNTAX II score (SS-II) can predict 4-year outcomes in patients with complex coronary artery disease and ST-segment elevation myocardial infarction (STEMI). Nonetheless, the prognostic value of SS-II for a cardiogenic shock (CS) in the setting of STEMI has not been assessed. Purpose This study aimed to investigate the predictive impact of SS-II in patients with CS complicating STEMI undergoing primary percutaneous coronary intervention, and whether SS-II adds prognostic information to predict major adverse cardiac events (MACE) and all-cause death in this population. Methods This prospective cohort study included 1965 consecutive patients with STEMI who underwent primary-PCI between January 2008 and December 2017. The cohort of patients with CS (n=153) was identified and divided into three groups based on SS-II tertiles [SS-II low tertile &lt;38 (n=51), ≥38 SS-II intermediate tertile &lt;47 (n=51), and SS-II high tertile ≥48 (n=51)]. Results Amongst the cohort of patients with CS mean age was 68.4±14.0 years, 69.2% were male and 51.6% presented with anterior STEMI (mean SSII was 45.1±14). In-hospital mortality was significantly higher in the high SS-II tertile (85.7% vs. 38.9% vs 24.4%, p≤0.001) compared with SS-II intermediate and low tertiles. During follow-up (median 2.5 years), SS-II was positively correlated with MACE (89.3% (high SS-II) vs. 52.8% (int SS-II) vs. 42.2% (low SS-II), p≤0.001), and with all-cause mortality (89.3% vs 44.4% vs 26.7%, p≤0.001). The SS-II was also an independent predictor of MACE (HR=1.042, 95% CI: 1.020–1.063, p=0.000) and all-cause mortality during follow-up (HR=1.056, 95% CI: 1.033–1.079, p=0.000) Conclusion In a real-world cohort of patients with STEMI related CS, the SS-II added important prognostic information, being an independent predictor of MACE and all-cause mortality during follow-up. Image 1 Funding Acknowledgement Type of funding source: None

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