Predictors of in-hospital mortality in patients with ST-segment elevation myocardial infarction undergoing pharmacoinvasive treatment

Predictors of in-hospital mortality in patients with ST-segment elevation myocardial infarction undergoing pharmacoinvasive treatment

Autor Falcão, Felipe José de Andrade Autor UNIFESP Google Scholar
Alves, Claudia Maria Rodrigues Autor UNIFESP Google Scholar
Barbosa, Adriano Henrique Pereira Autor UNIFESP Google Scholar
Caixeta, Adriano Autor UNIFESP Google Scholar
Sousa, Jose Marconi Almeida Autor UNIFESP Google Scholar
Souza, José Augusto Marcondes de Autor UNIFESP Google Scholar
Amaral, Amaury Google Scholar
Wilke, Luiz Carlos Google Scholar
Perez, Fatima Cristina A. Google Scholar
Goncalves Junior, Iran Autor UNIFESP Google Scholar
Stefanini, Edson Autor UNIFESP Google Scholar
Carvalho, Antonio Carlos Autor UNIFESP Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Secretaria de Saude do Municipio de São Paulo
Hospital Municipal Tatuape
Resumo OBJECTIVES: To identify predictors of in-hospital mortality in patients with acute myocardial infarction undergoing pharmacoinvasive treatment. METHODS: This was an observational, prospective study that included 398 patients admitted to a tertiary center for percutaneous coronary intervention within 3 to 24 hours after thrombolysis with tenecteplase. ClinicalTrials.gov: NCT01791764 RESULTS: The overall in-hospital mortality rate was 5.8%. Compared with patients who survived, patients who died were more likely to be older, have higher rates of diabetes and chronic renal failure, have a lower left ventricular ejection fraction, and demonstrate more evidence of heart failure (Killip class III or IV). Patients who died had significantly lower rates of successful thrombolysis (39% vs. 68%; p = 0.005) and final myocardial blush grade 3 (13.0% vs. 61.9%; p<0.0001). Based on the multivariate analysis, the Global Registry of Acute Coronary Events score (odds ratio 1.05, 95% confidence interval (CI) 1.02-1.09; p = 0.001), left ventricular ejection fraction (odds ratio 0.9, 95% CI 0.89-0.97; p = 0.001), and final myocardial blush grade of 0-2 (odds ratio 8.85, 95% CI 1.34-58.57; p = 0.02) were independent predictors of mortality. CONCLUSIONS: In this prospective study that evaluated patients with ST-segment elevation myocardial infarction treated by a pharmacoinvasive strategy, the in-hospital mortality rate was 5.8%. The Global Registry of Acute Coronary Events score, left ventricular ejection fraction, and myocardial blush were independent predictors of mortality in this high-risk group of acute coronary syndrome patients.
Palavra-chave Myocardial Infarction
Mortality
Pharmacoinvasive Therapy
Idioma Inglês
Data de publicação 2013-12-01
Publicado em Clinics. Faculdade de Medicina / USP, v. 68, n. 12, p. 1516-1520, 2013.
ISSN 1807-5932 (Sherpa/Romeo, fator de impacto)
1980-5322 (Sherpa/Romeo, fator de impacto)
Publicador Faculdade de Medicina / USP
Extensão 1516-1520
Fonte http://dx.doi.org/10.6061/clinics/2013(12)07
Direito de acesso Acesso aberto Open Access
Tipo Artigo
Web of Science WOS:000329985900007
SciELO S1807-59322013001201516 (estatísticas na SciELO)
Endereço permanente http://repositorio.unifesp.br/handle/11600/8040

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