Several Medical and Social Factors Which May Influence in-Hospital Mortality in Patients With Myocardial Infarction

Крючков, Д. В.; Херасков, Виталий Юрьевич; Максимов, Сергей Алексеевич; Артамонова, Г. В.

doi:10.15690/vramn.v68i11.840

Cited by 4 publications

(4 citation statements)

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“…Older age as such was shown to be an independent risk factor for IHD [22]. It is also linked to the severity of the IHD condition [23]. Older adults, as per the findings of a recent UK-based study, were less likely to engage in physical activity; therefore they place themselves at an increased risk of cardiovascular disease [24].…”

Section: Discussionmentioning

confidence: 89%

Cardiovascular mortality in Northern Ireland during the 2008-2014 financial crisis years: who got the worst hit?

Osman

Osman²

2022

ebph

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Background: Internationally, cardiovascular mortality and economic recessions showed an established relationship. Northern Ireland was badly affected by the global financial crisis in 2008-2014 but little is known in terms of how cardiovascular mortality was affected. Objective: The aim of the present study was to investigate the potential impact of the 2008 economic crisis on the annual cerebrovascular accidents CVA and ischaemic heart disease IHD related mortality in Northern Ireland. Method: Mortality data were extracted from Northern Ireland Statistics and Research Agency database. We utilized generalized linear regression Poisson modelling to estimate the impact of economic crisis on the IHD and CVA mortality. Results: We found a significant increase of IHD-deaths during the financial crisis years in males over the age of 65 (β = 49.466, p value = 0.003) and females over the age of 65 (β = 57.721, p value = 0.001). However, CVA-mortality in the post crisis years rose significantly for females who were 65 years or older (β = 56.010, p value = 0.005) but not for males. The rest of the age groups were not significantly affected in terms of either CVA or IHD mortality. Conclusion: For the total population the only age category with significant increase in both IHD and CVA mortality in the post-2008 era was the over 65 (p values < 0.001 and = 0.012, respectively) Declaration of interest: None. Keywords: IHD, CVA, Northern Ireland, economic recession, working-age, socio-economic changes

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Section: Discussionmentioning

confidence: 89%

Cardiovascular mortality in Northern Ireland during the 2008-2014 financial crisis years: who got the worst hit?

Osman

Osman²

2022

ebph

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“…Летальность в группе пациентов с ИМ составила 10,3% (n=12), что незначительно ниже данных, полученных в исследовании Д.В. Крючкова с соавт., в котором на госпитальном этапе умерло 764 (11,8%) пациента с ИМ [10]. Результаты Хабаровского регистрового исследования, включающего анализ данных 321 пациента с ИМ (135 пациентов с ИМбпST и 177 пациентов с ИМпST) [11] и исследования ЛИС [12] демонстрировали также более высокую госпитальную летальность (15,2%) по сравнению с данными собственного исследования.…”

Section: Discussionunclassified

Evaluation of Procalcitonin Levels in Patients with Various Forms of Acute Coronary Syndrome, Depending on the Presence of Adverse Hospital Outcomes

Драпкина¹,

Zakharova²

2021

Racionalʹnaâ farmakoterapiâ v kardiologii

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Aim. to study the levels of procalcitonin in patients with various forms of acute coronary syndrome (ACS), depending on the presence of adverse hospital outcomes.Materials and Methods. The study included 222 patients admitted to the emergency cardiology department with a diagnosis of ACS in the period from March 2014. until January 2017. Of these, 106 (47.7 %) patients were diagnosed with unstable angina (NS) and 116 (52.3%) with myocardial infarction (MI). Non ST segment elevation MI (NSTEMI) was diagnosed in 47 (40.5%) patients with MI, and ST elevation MI (STEMI) – in 69 (59.5%) patients with MI. After the assessment of the patient's compliance with the criteria for inclusion/exclusion in the study, the procedure for signing the patient's informed consent form was carried out. The protocol of the study was approved by the local Ethics committee of the M. E. Zhadkevich State Clinical Hospital. In each study subgroup, the presence of adverse outcomes during the current hospitalization was assessed: cardiovascular death, nonfatal MI, nonfatal acute cerebrovascular accident, acute heart failure, as well as a combined endpoint, including all of the listed adverse outcomes. All patients, in addition to routine laboratory methods of investigation, were examined for the level of procalcitonin at admission to the hospital, on 2-3 and 4-5 days.Results. Patients with MI compared to patients with NS were characterized by a large number of registered endpoints in general (24.1% vs. 6.6%, p<0.001), while in the group of patients with MI, cardiovascular death was more often recorded (10.3% vs. 0.9%, p<0.001) and acute heart failure (12.9% vs. 5.6%, p=0.009). Patients with MI, in particular with STEMI, who had adverse hospital outcomes, were characterized by statistically significantly higher levels of procalcitonin compared to patients without adverse hospital outcomes. Patients with STEMI showed significantly higher levels of procalcitonin at all stages of the disease, and patients with MI-only at 2-3 and 4-5 days. There were no statistically significant differences in the level of procalcitonin at all stages of the disease in patients with NSTEMI and with unstable angina, depending on the hospital outcomes.Conclusion. Elevated procalcitonin levels in patients with MI, in particular with STEMI, are associated with adverse hospital outcomes; for other forms of ACS, no statistically significant differences were observed with different hospital outcomes.

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“…Особенности анамнеза, с другой стороны, в опреде-ленной степени обусловливают наличие и количество противопоказаний к лекарственной терапии и ограниче-ние выбора лечащим врачом оптимальных методов диа-гностики и лечения, что также может влиять на госпиталь-ный прогноз [12] и смертность в отдаленный период после развития ИМ.…”

Section: Discussionunclassified

“…С другой стороны в ранее проведенных нами исследованиях показана более высокая госпитальная летальность при ИМ у мужчин работоспособного возраста по сравнению с женщинами той же возрастной группы. Так, госпитальная летальность у мужчин работоспособного возраста составила 5,0%, у женщин -1,7% (р=0,025) [12].…”

Section: Discussionunclassified

Occupational Role and Long-Term Survival After Myocardial Infarction

Крючков¹,

Максимов²,

Кущ³

et al. 2015

Ross. kardiol. ž.

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Цель. Провести анализ влияния трудовой занятости на отдаленную выживае-мость после инфаркта миокарда (иМ). Материал и методы. Объем выборки составил 471 пациент; из них 342 муж-чины, 129 женщин. среди них работающих на момент развития иМ -118 человек, неработающих -353. сравнение выживаемости проводилось мето-дом Каплана-Майера, критерием Гехана-Вилкоксона. Для устранения влияния пола и возраста перед расчетом рисков проводилась прямая стандартизация смертности по двум данным факторам. Для оценки риска недожития у нерабо-тающих по сравнению с работающими рассчитывались добавочный риск (EF) и отношение шансов (OR) с 95% доверительным интервалом (Ди). Результаты. Выживаемость после перенесенного иМ в группе работающих выше, по сравнению с неработающими (р=0,00006). К 8-му году показатель выживших среди работающих составляет 70%, в то время как среди неработающих -лишь 42%. Риски недожития до 5-ти лет после иМ у неработающих по сравнению с рабо-тающими достигают статистической значимости: EF составляет 13,4% при 95% Ди от 3,2% до 23,6%, OR равен 1,78 при 95% Ди от 1,14 до 2,78. Заключение. Результаты проведенного исследования свидетельствуют о более высокой выживаемости в отдаленный период работающего населения по сравнению с неработающим, что проявляется уже в первые месяцы после развития иМ. с увеличением временного периода от момента развития иМ различия в выживаемости в зависимости от трудовой занятости увеличиваются. ФГБНУ Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний, Кемерово, России.Крючков Д. В.* -к. м.н., с. н.с., лаборатории моделирования управленческих техно-логий, отдел оптимизации медицинской помощи при сердечно-сосудис тых забо-леваниях, Максимов с. А. -к. м.н., доцент, в. н.с. лаборатории эпидемиологии сердечно-сосудистых заболеваний, отдел оптимизации медицинской помощи при сердечно-сосудистых заболеваниях, Кущ О. В. -к. м.н., в. н.с., лаборатории моде-лирования управленческих технологий, отдел оптимизации медицинской помощи при сердечно-сосудистых заболеваниях, Артамонова Г. В. -д. м.н., профессор, заместитель директора по научной работе, заведующая отделом оптимизации медицинской помощи при сердечно-сосудистых заболеваниях. Aim. To analyze the influence of occupational role on long-term survival after myocardial infarction (MI). Material and methods. The volume of selection was 471 patient; of those 342 men, 129 women. Among them at the moment of MI 118 had a job, and 353 had not. Comparison of survival was done by Kaplan-Meier method, criteria by gekhan-Wilkokson. To eliminate the influence of gender and age on the statistics, before the risk assessment we directly standardized mortality by both these factors. For the risk of premature death in non-workers in comparison to current workers we measured an additional risk (EF) and odds ratio (OR) with 95% confidence interval (CI). Results. Survival rate after MI in current workers group was higher than in nonworkers (p=0,00006). By the 8th year the level of survived among workers is 70%, and in non-workers -j...

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Several Medical and Social Factors Which May Influence in-Hospital Mortality in Patients With Myocardial Infarction

Abstract: Aim: to study the medical and social aspects of in-hospital mortality after myocardial infarction (MI) (Вестник РАМН. 2013; 11: 30-33)

Cited by 4 publications

References 1 publication

Cardiovascular mortality in Northern Ireland during the 2008-2014 financial crisis years: who got the worst hit?

Cardiovascular mortality in Northern Ireland during the 2008-2014 financial crisis years: who got the worst hit?

Evaluation of Procalcitonin Levels in Patients with Various Forms of Acute Coronary Syndrome, Depending on the Presence of Adverse Hospital Outcomes

Occupational Role and Long-Term Survival After Myocardial Infarction

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