Predictors of the adverse course at hospital stage of Q-myocardial infarction treatment
DOI:
https://doi.org/10.34287/MMT.3(42).2019.11Abstract
Purpose of the study. Identify predictors of the course adverse at hospital stage of Q-myocardial infarction treatment.
Materials and methods. The study involved 139 patients in the acute stage of Q-MI, average age 66 ± 0,97 year, male – 59%. Patients underwent a general clinical examination, determined the level of glycemia on admission, copeptin, NTproBNP, left ventricular ejection fraction (LVEF). 101 patients have reached cumulative endpoint (CEP), average age of 68 ± 1,02 years, of which male were 57%. As the CEP were considered one of the occurrence adverse events: death on the hospital stage (n = 17, average age 70,4 ± 2,37 years, male – 53%), development of acute heart failure (n = 94, Killip II – n = 52, Killip III n = 42, 52% were male, average age 69,2 ± 8,3 years), decreased LVEF < 45% (n = 64, average age 66 ± 1,22 years, male 63%).38 patients did not have a single endpoint, the average age 62 ± 2,2 years, male 67%.
Results. According to multivariate logistic regression analysis, independent risk factors for increased risk of intra-hospital mortality were copeptin level more than 0,87 ng/ml, which increased the odds ratio (OR) by 1,4651 times (p = 0,014) and hyperglycemia on admission more than 9,0 mmol/L, which increased intrahospital mortality by 1,2 times (p = 0,006). Independent risk factors for achieving the CEP were tachycardia (OR = 3,19; p = 0,009), increased copeptin level more than 3,3 pmol/L (OR = 1,52; p = 0,01) and hyperglycemia more than 9,3 mmol/l (OR = 1,20; p = 0,02).
Conclusion. Independent risk factors of increasing intra-hospital mortality were the level of copeptin more than 0,87ng/ml and hyperglycemia on admission more than, 9 mmol/l. Dependent and independent risk factors for CEP were tachycardia, an increase in the level of copeptin over 3,3 ng/ml and hyperglycaemia on admission more than 9,3 mmol/l.
References
Kovalenko NV, Chichkova MA, Abdulkerimova AA, Chichkova YM. Optimization of treatment of myocardial infarction with ST segment elevation against the background of chronic herpes virus infection. Sovremennyye problemy nauki i obrazovaniya. 2016; 5. http://www.science-education.ru/ru/article/ view?id=25257.
Ferreira-González I. Epidemiologia de la enfermedad coronaria. Rev Esp Cardiol. 2014 ; 67 (2): 139–144. DOI: 10.1016/j.recesp.2013.10.003.
Benjamin EJ, Virani SS, Callawey CW, Chamberlain AM et al. Heart Disease and Stroke Statistic.–2018Update:AReportFromtheAmerican Heart Association. Circulation. 2018; 137 (12): e67–e492. DOI: 10.1161/CIR.0000000000000558.
Steg PG, James SK, Atar D et al. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology. Eur Heart J. 2012; 33 (20): 2569-619. DOI: 10.1093/eurheartj/ehs215.
Tseluiko VY, Mishchuk NE, Matuzok OE. Study of indicators affecting clinical forecast and heart remodeling in the late period in patients with infarction ST segment elevation myocardium. Scientific Journal «ScienceRise: Medical Science». 2017; 11 (19): 36–43. DOI: 10.15587/2519-4798.2017.116676
Moghissi ES, Korytkowski MT,DiNardoMet al. American association of clinical endocrinologists and American diabetes association consensus statement on inpatient glycemic control. Diabetes Care. 2009: 32 (6): 1119–1131. DOI.org/10.2337/ dc09-9029.
Lang RM, Badano LP, Mor-Avi V, Afilalo J et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015; 28 (1):1–39. e14. DOI: 10.1016/j.echo.2014.10.003.
Dandona P, Chaudhuri A. Diabetes: Glycaemia and insulin after acute myocardial infarction. Nat Rev Endocrinol. 2014; 10 (8): 448–450. DOI: 10.1038/nrendo.2014.101.
Deckers JW, Van Domburg RT, Akkerhuis M, Nauta ST. Relation of admission glucose levels, shortand long-term (20-year) mortality after acute myocardial infarction. Am J Cardiol. 2013; 112 (9): 1306–1310. DOI: 10.1016/j.amjcard.2013.06.007.
Timmer J, Hoekstra M, Nijsten, M, van der Horst IS et al. Prognostic value of admission glycosylated hemoglobin and glucose in nondiabetic patients with ST-segment-elevation myocardial infarction treated with percutaneous coronary intervention. Circulation. 2011; 124 (6): 704–711. DOI: 10.1161/circulationaha.110.985911.
Kim EJ, Jeong MH, Kim JH, Ahn TH et al. Clinical impact of admission hyperglycemia on inhospital mortality in acute myocardial infarction patients. Int J Cardiol. 2017; 236: 9–15. DOI: 10.1016/j.ijcard.2017.01.095.
Wiviott SD, Morrow DA, Frederick PD, Antman EM et al. National Registry of Myocardial Infarction. Application of the Thrombolysis in Myocardial Infarctionriskindexinnon-ST-segment elevation myocardial infarction: evaluation of patients in the National Registry of Myocardial Infarction. J Am Coll Cardiol. 2006; 47 (8): 1553–1558. DOI: 10.1016/j.jacc.2005.11.075.
Yang HY, Ahn MJ, Jeong MH, Ahn Y, Kim YJ et al. Predictors of In-Hospital Mortality in Korean Patients with Acute Myocardial Infarction. Chonnam Med J. 2019; 55 (1): 40–46. DOI.org/10.4068/cmj.2019.55.1.40.
Schurtz G, Lamblin N, Bauters C, Goldstein P, Lemesle G . Copeptin in acute coronary syndromes and heart failure management: State of the art and future directions. Archives of Cardiovascular Diseases. 2015; 108 (6–7): 398–407. DOI: 10.1016/j.acvd.2015.04.002.
Ananth V, Beig JR, Tramboo NA et al., Does Plasma copeptin levelatadmis sionpredictfinalinfarctsizein STelevation myocardial infarction. Int. J. Cardiol. 2016; 219: 326–330.
O’Malley RG, Bonaca MP, Scirica BM, Murphy SA et al. Prognostic performance of multiple biomarkers in patients with non-ST-segment elevation acute coronary syndrome: analysis from the MERLIN-TIMI 36 trial (Metabolic Efficiency With Ranolazine for Less Ischemia in NonST-Elevation Acute Coronary SyndromesThrombolysis In Myocardial Infarction 36). J Am Coll Cardiol. 2014; 63 (16): 1644–1653. DOI: 10.1016/j.jacc.2013.12.034.
Benoit Lattuca B, Sy V, Nguyen LS, Bernard M et all. Copeptin as a prognostic biomarker in acute myocardial infarction. Int J Cardiol. 2019; 274: 337–341. DOI: 10.1016/j.ijcard.2018.09.022.
Gu YL, Voors AA, Zijlstra F, Hillege HL et al. Comparison of the temporal release pattern of copeptin with conventional biomarkers in acute myocardial infarction. Clinical Research in Cardiology. 2011; 100 (12): 1069–1076. DOI: 10.1007/s00392-011-0343-y.
Kelly D, Squire IB, Khan SQ, Quinn P et al. C-terminal provasopressin (copeptin) is associated with left ventricular dysfunction, remodeling, and clinical heart failure in survivors of myocardial infarction. J Card Fail. 2008; 14 (9): 739–745. DOI: 10.1016/j.cardfail.2008.07.231.
Syvolap VD, Kapshytar NI. Predictors of development of acute heart failure in patients with acute period ofmyocardial Q-infarction. Zaporizkyy medychnyy zhurnal. 2019; 2 (113): 160–164 DOI:10.14739/2310-1210.2019.2.161319.
Voors AA, von Haehling S, Anker SD, Hillege HL, et al. C-terminal provasopressin (copeptin) is a strong prognostic marker in patients with heart failure after anacute myocardial infarction: results fromthe OPTIMAAL study. Eur Heart J. 2009; 30: 1187–1194. DOI: 10.1093/eurheartj/ehp098.
Kremneva LV. The value of co-peptin for the diagnosis of myocardial infarction. Rossiyskiy kardiologicheskiy zhurnal. 2017; 151 (11): 93–97. http://dx.doi.org/10.15829/1560-4071-2017-11-93-9.
Khan SQ, Dhillon OS, O’Brien R.J, Struck J et al. C-terminal provasopressin (copeptin) as a novel and prognostic marker in acute myocardial infarction: Leicester Acute Myocardial Infarction Peptide (LAMP) study. Circulation. 2007; 115 (16): 2103–2110. DOI: 10.1161/circulationaha.106.685503.
