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Prospective study on myocardial infarction: short-term prognostic factors

Introduction

MI is one of the major causes of mortality and morbidity worldwide. Our resources in approaching and treating this entity are restricted due to financial causes. Studying the risk factors helps to improve health services and to provide better care where most needed.

Methods and materials

In this observational longitudinal study patients with diagnosis of acute MI admitted at Rasoul akram ED during 21 months were included. The risk factors, primary and secondary endpoint outcomes were registered on a form. Primary endpoints were defined as death and need to CPR, and secondary endpoints were defined as death, asymptomatic, CCU admission, need to CPR, and angiography result when it was performed. Two months later, secondary endpoints were followed-up by telephone.

Results

One hundred and fifty-four patients were included. Twenty-one percent of patients died. Low Hgb level (P = 0.037) and leukocytosis (P = 0.011) are related to patient death. Mean age was 70.5 ± 2.28 and 56.5 ± 1.06 years in dead and alive patients, respectively (P = 0.000). Angiostenosis, previous MI and heart failure increase the mortality risk to 10 times (P = 0.000), 3.8 times (P = 0.01) and 3.2 times (P = 0.003), respectively. Mean interval time between appearance of the symptoms and fibrinolytic therapy in ST-elevation MIs was 2.31 (± 0.22) hours, there was no mortality when fibrinolytic therapy was started less than 0.5 hours from symptoms, and only one mortality when it was started at less than 1 hour. Sex distribution was not related to either primary or secondary endpoint outcomes. There was no relationship between patients' 2-month survival and HTN, DM, HLP, dysrhythmia, blocks, ST elevation, involved aspect of the heart and fibrinolytic therapy.

Discussion

Mean age > 70 years, angiostenosis, previous MI, heart failure, low Hgb level and leukocytosis are associated with poor prognosis in MI patients. Early thrombolytic therapy decreased mortality but has no effect on 2-month outcome.

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Zare, M., Kianmehr, N., Hosseinnejad, A. et al. Prospective study on myocardial infarction: short-term prognostic factors. Crit Care 9, P317 (2005). https://doi.org/10.1186/cc3380

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Keywords

  • Heart Failure
  • Myocardial Infarction
  • Mortality Risk
  • Secondary Endpoint
  • Thrombolytic Therapy