2021, Number 4
Acute myocardial infarction risk index for patients with chest pain admitted to the emergency department
Language: Spanish
References: 26
Page:
PDF size: 261.80 Kb.
ABSTRACT
Introduction: cardiovascular diseases (CVD) are the leading cause of death in developed and developing countries, within them; coronary heart disease (CD) is the single most frequent cause of death worldwide.Objective: to design an index to predict the risk of acute myocardial infarction in the emergency department in patients with acute chest pain.
Method: a prospective logistic regression cohort study was carried out in patients with chest pain treated in the emergency department of the General University Hospital "Carlos Manuel de Céspedes" of the Bayamo municipality, Granma, who met the inclusion and exclusion criteria, determining the Clinical variables related to the risk of acute myocardial infarction in the emergency department in patients with acute chest pain.
Results: in the clinical profile of the patients in the cohort, the majority had a history of ischemic heart disease (220 for 71.0%) and the presence of typical pain is distinguished in the highest percentage of patients (183 for 59, 0), all the variables of the clinical profile were significantly related to the appearance of acute myocardial infarction. Typical pain was the most significant almost four times when compared to patients with non-typical pain (OR: 3.894; CI: 2.302-6.590; p: 0.000). The Hosmer and Lemeshow test shows that the data fit the model (p = 0.441). The analysis of the internal validity of the index to predict the risk of developing acute myocardial infarction results in a validity index of 73.08%. Similarly, the sensitivity was adequate (87.75%). The very high negative predictive value (95.18%) indicates that the index is unlikely to classify individuals who become ill as low risk. The validity of content and presentation according to expert opinions, the criterion prevails that the index meets the established requirements.
Conclusions: the clinical profile of the investigated patients was significantly related to the risk of acute myocardial infarction, where the value of typical chest pain stands out, and secondly, the designed index, based on the clinical profile of the patients, allows predicting the appearance of acute myocardial infarction with adequate validity.
REFERENCES
Gil Román JJ. Análisis de la actividad de una unidad funcional de dolor torácico vinculada a un servicio de urgencias hospitalario: condicionantes clínicos y organizativos. [Internet]. España: Universidad de Oviedo; 2016. [citado 19/12/2020]. Disponible en: https://digibuo.uniovi.es/dspace/bitstream/handle/10651/39412/Gil%20Roman.pdf?sequence=3&isAllowed=y.
Ibañez B, James S, Agewall S, Antunez MJ, Bucciarelli-Ducci Ch, Bueno H. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J 2018; 39(2): 119-77.
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