Acute myocardial infarction: predictors of mortality at a public hospital in the city of Fortaleza, Ceará state

Abstract

OBJECTIVE: To identify the clinical and demographic predictors of in-hospital mortality in acute myocardial infarction with elevation of the ST segment in a public hospital, in the city of Fortaleza, Ceará state, Brazil. METHODS: A retrospective study of 373 patients experiencing their first episode of acute myocardial infarction was carried out. Of the study patients, 289 were discharged from the hospital (group A) and 84 died (group B). Both groups were analyzed regarding: sex; age; time elapsed from the beginning of the symptoms of myocardial infarction to assistance at the hospital; use of streptokinase; risk factors for atherosclerosis; electrocardiographic location of myocardial infarct; and Killip functional class. RESULTS: In a univariate analysis, group B had a greater proportion of the following parameters as compared with group A: non-Killip I functional class; diabetes; age >70 years; infarction of the inferior wall associated with right ventricular impairment; time between symptom onset and treatment at the hospital >12 h; anteroseptal or extensive anterior infarction; no use of streptokinase; and no tobacco use. In a multivariate logistic regression analysis, only non-Killip I functional class, diabetes, and age >70 years persisted as independent factors for death. CONCLUSION: Non-Killip I functional class, diabetes, and age >70 years were independent predictors of mortality in acute myocardial infarction with elevation of the ST segment

Evaluation of risk factors in acute myocardial infarction patients admitted to the coronary care unit, Tripoli Medical Centre, Libya

“…This ratio is similar to the sex ratio recorded in 2 British communities [14] and reflects the fact that women with acute ischaemic syndromes tend to be older than men with such syndromes [16]. In the present study, the ratio of the number of patients > 60 years of age to those ≤ 60 years was 1.0:1 in male patients and 3.3:1 in female patients Diabetes is a major independent predictor of morbidity and mortality in acute MI [7], probably through its associations with pre-existing left ventricular dysfunction and diffuse and rapidly progressive coronary atherosclerosis [17]. The current data indicated that 48.2% of all patients hospitalized at Tripoli medical centre with acute MI had diabetes.…”

“…The prevalence of acute MI as the first manifestation of ischaemic heart diseases is high in approximately 50% to 70% of patients and is a common cause for hospital admission [5]. Several factors related to the severity of the disease have been identified, such as smoking [6], diabetes mellitus [7], systemic arterial hypertension [8], dyslipidaemia [1], the number of arteries impaired and degree of functional impairment of the left ventricle [9]. Furthermore, age, sex, obesity, heavy alcohol consumption and physical inactivity were all also recognized as contributory factors [1].…”

The challenges in the management of right ventricular infarction

“…22 However, although the number of patients with RV infarction is small, these patients seem to have a higher risk of in-hospital mortality in the mechanical reperfusion era than during the fibrinolytic era. Figure 2 shows the changes in the in-hospital mortality rate and relative risk of RV infarction for in-hospital mortality between the fibrinolytic and mechanical reperfusion era; 8,[23][24][25][26][27][28][29][30][31][32][33][34][35][36] An increase in the relative risk of RV infarction from 2.29 (95% CI 1.67-3.14) to 2.98 (95% CI 1.41-6.31) also occurred during this period. The precise explanation for the paradox remains unknown.…”

“…These data were derived from previously published meta-analyses, 21 which included many prospective or retrospective studies, assessing the impact of RV infarction in patients with acute MI up to June 2007, 8,[23][24][25][26][27][28][29][30][33][34][35][36] and two additional observational studies that met the same inclusion criteria up to June 2012. 31,32 of concomitant LV involvement, this study indicated that the mean optimal PWP, which corresponded to the maximum LV stroke work index in each patient, was 16 mmHg.…”

Acute Myocardial Infarction Risk Factors and Correlation of its Markers with Serum Lipids

“…Diabetes is a major independent predictor of morbidity and mortality in acute MI. 17,18 Smoking was the second risk factor among male patient (51.2%), but all the female patients sample were not smoker, this because, the smoking is not an habit among females in most of Arabian and Islamic countries. Smoking appeared to be the second most common risk of AMI.…”