Prognostic implications for patients after myocardial infarction: an integrative literature review and in-depth interviews with patients and experts

Abstract

Background As patients with myocardial infarction (MI) survive for a long time after acute treatment, it is necessary to pay attention to the prevention of poor prognosis such as heart failure (HF). To identify the influencing factors of adverse clinical outcomes through a review of prospective cohort studies of post-MI patients, and to draw prognostic implications through in-depth interviews with post-MI patients who progressed to HF and clinical experts. Methods A mixed-method design was used that combined a scoping review of 21 prospective cohort studies, in-depth interviews with Korean post-MI patients with HF, and focus group interviews with cardiologists and nurses. Results A literature review showed that old age, diabetes, high Killip class, low left ventricular ejection fraction, recurrent MI, comorbidity of chronic disease and current smoking, and low socioeconomic status were identified as influencing factors of poor prognosis. Through interviews with post-MI patients, these influencing factors identified in the literature as well as a lack of disease awareness and lack of self-care were confirmed. Experts emphasized the importance of maintaining a healthy lifestyle after acute treatment with the recognition that it is a chronic disease that must go together for a lifetime. Conclusion This study confirmed the factors influencing poor prognosis after MI and the educational needs of post-MI patients with transition to HF. Healthcare providers should continue to monitor the risk group, which is expected to have a poor prognosis, along with education emphasizing the importance of self-care such as medication and lifestyle modification.

Short-Term Prognostic Value of the Culprit-SYNTAX Score in Patients with Acute Myocardial Infarction

“…Additional independent predictors of primary outcomes include age, STEMI presentation, Killip class > 1, and cul-SS. Age, STEMI presentation, Killip class > 1, and cardiogenic shock on admission are well-known predictors of both short-and long-term mortality and morbidity [18][19][20]. In addition, cul-SS was found to be a short-term prognostic predictor.…”

Guía latinoamericana de recomendaciones al egreso de un síndrome coronario agudo

“…La dislipidemia se debe controlar con tratamiento farmacológico e intervenciones en el estilo de vida en los pacientes que han sufrido un SCA, debido a que se trata de uno de los principales factores de riesgo del inicio y la progresión de la enfermedad coronaria. De hecho, el colesterol debe considerarse como un factor etiopatogénico y no solo como un factor de riesgo [1][2][3][4][5][6][7][8][9][10][11] . Las estatinas son los fármacos hipolipidemiantes de elección [279][280][281][282][283][284][285][286][287][288][289][290] .…”

“…Está demostrado que el riesgo de un evento recurrente será proporcionalmente mayor cuanto mayor sea la carga de estos factores 3 . La presencia acumulada de las condiciones mencionadas se ha asociado con un aumento incremental en la tasa de ECV que llega hasta 9.98 por 10,000 personas/año.…”

Timing of heart failure development and clinical outcomes in patients with acute myocardial infarction

“…With the advances in both optimal revascularization and medical therapy, the survival rate after AMI have improved, on the other hand, the incidence of HF associated with MI also has been increased (2,3). The development of HF after an index MI is known to be associated with poor clinical outcomes (4,5).…”