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2013, Número 1

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CorSalud 2013; 5 (1)


Valor predictivo de algunos modelos de estratificación de riesgo en pacientes con infarto agudo de miocardio con elevación del ST

Cordero SQM, Ramírez GJI, Moreno-Martínez FL, González AO

Idioma: Español
Referencias bibliográficas: 58
Paginas: 57-71
Archivo PDF: 994.26 Kb.


RESUMEN

Introducción y objetivos: Establecer el pronóstico adecuado en pacientes que han sufrido un infarto de miocardio ha sido una expectativa de los médicos desde tiempos remotos. El objetivo de este estudio fue determinar el valor predictivo de tres modelos de estratificación de riesgo en pacientes con infarto agudo de miocardio con elevación del ST.
Método: Se realizó un estudio descriptivo longitudinal en 150 pacientes con esta enfermedad, ingresados en el Servicio de Cardiología del Hospital Provincial Universitario “Arnaldo Milián Castro” de Villa Clara, Cuba, en el período comprendido de enero de 2010 a diciembre de 2011.
Resultados: Los pacientes presentaron una edad media de 66,47 años. Predominaron el sexo masculino (62 %) y el infarto de cara inferior (57,3 %). Todos los pacientes complicados o fallecidos fueron clasificados como alto riesgo, según la escala GRACE; y el índice “C” para complicaciones graves y muerte intrahospitalaria tuvo muy buena capacidad predictiva. En el Índice pronóstico, el 57,2 % de los pacientes complicados y el 46,4 % de los fallecidos fueron de alto riesgo, con un índice “C” de 0,67 y 0,65, respectivamente, también existió una pobre capacidad predictiva para ambos eventos. La escala ICR obtuvo un índice “C” de 0,45 para complicaciones graves y 0,41 para mortalidad intrahospitalaria, ambos con muy mala capacidad predictiva.
Conclusiones: La escala GRACE presentó muy buena capacidad para predecir complicaciones graves y muerte intrahospitalaria; sin embargo, la escala Índice pronóstico mostró pobre capacidad predictiva para ambos suceso al no clasificar adecuadamente a los pacientes con valores extremos. La escala ICR presentó un índice “C” con mala capacidad predictiva para ambos sucesos.


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