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2011, Number 1

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Rev Cub Med Int Emerg 2011; 10 (1)

Acute ventricular dysfunction in the myocardial acute infarction

Rubiera JR, Lara NA, Vilardebo RMA

Language: Spanish
References: 47
Page: 2068-2082
PDF size: 185.85 Kb.


ABSTRACT

Introduction: The acute ventricular dysfunction is a well known complication of Acute Coronary Syndrome falling into negatively in morbidity and mortality.
Objective: To analyze the behavior of the cardiac insufficiency in patients diagnosed with myocardial acute infarction.
Method: A retrospective study was conducted in 149 patients admitted in the Intensive Therapy Unit and in Emergency Room of the “Comandante Piti Fajardo” Hospital from January, 2008 to June, 2009. The statistical analysis was based on the descriptive statistic techniques, using measure units in number end percentage. When it was necessary the Chi2 test was carried out, the Yates’s correlation or the Fisher’s exact test.
Results: In the analysis of risk factors there was predominance of dyslipemia for a 94,6 % (n = 141), followed by HTA for a 91.9 % (n= 137) and diabetes mellitus for a 77.8 % (n = 116). The AMI of the lower face prevails with a 53 % (n = 80). Total of patients with less than 12 hours of total ischemia time had thrombolytic treatment en ‹ 6 hours. There was a mortality of 14.7 % (n = 22) with a total of discharged alive patients of 85.2 % (n= 127), the 79,9 % (n = 119) of the Killip-Kimball Class (KK) I were discharged alive, only a 1.3 % (n = 2) deceased.
Conclusions: There was predominance of male patients aged over 71 with KK III and IV, as well as the HTA and the dyslipemia as the more relevant pathological backgrounds. In the severe ways of ICC III and IV were more frequent the AMI of lower face with extension to the right ventricle, followed by the AMI anterior extent. The cardiac insufficiency In the AMI is associated with a less use of STK and a ischemia total time greater than 12 hours. The mortality increases in the more severe ways of cardiac insufficiency.


REFERENCES

  1. Krumholz HM, Chen YT, Wang Y, Vaccarino V, Radford MJ, Horwitz RI (2000). «Predictors of readmission among elderly survivors of admission with heart failure». AM. Heart J. 139 (1 Pt 1): 72-7. PMID 10618565.

  2. Anuario de salud. Ministerio de Salud Publica Cuba, 2008.

  3. The Criteria Committee of the New York Heart Association. Nomenclature and Criteria for Diagnosis of Diseases of the Heart and Great Vessels ACC: American College of Cardiology; AHA: American Heart Association. 9na ed. Little BROS & Co; 1994. p. 253-6)

  4. Vargas-Barróna J, Romero-Cárdenasa A, Roldána FJ, Vázquez-Antona CA. Infarto agudo de aurícula y ventrículo derechos. Rev Esp Cardiol[Internet]2007[citado 10 nov 2009];60::[aprox.51p.].

  5. Piñón Pérez J, Sandrino Sánchez M, Flores Podadera H, Delgado Rodríguez AE, Fernández González JL, León Pimentel, OA. Mortalidad oculta por infarto agudo del miocardio. Hospital Universitario "Abel Santamaría" Pinar del Río. Rev Cub Med 2003; 42(5)

  6. Elias Sierra R, Choo Ubals T, Bodelois Abdo M, Elias Armas S. Infarto Agudo del Miocardio. Correlación clínica - patológica en el Hospital Universitario Dr. Agostinho Facultad de Medicina Guantánamo, Cuba, 1991 –2002. Guantánamo CUBA http www.conganat.org 7

  7. Anales de Cirugía Cardíaca y Vascular 2000;6(3):126-132 Rafael Pila Pérez Aquiles J. Rodríguez López2 Gustavo Padron2 Osmany Risco3 Rafael Pila Peláez3 Kafui Kwaku4 Infarto de miocardio agudo en ancianos. Estudio comparativo. Cv2000_3/ac-6-3-004.).

  8. Bragulata E, López B, Miróa O, Coll-Vinenta B, Jiménez S, Aparicioa MJ et al. Análisis de la actividad de una unidad estructural de dolor torácico en un servicio de urgencias hospitalario. Rev Esp Cardiol [Internet] 2007[citado 10 nov 2009]; 60:[aprox.27p.].

  9. Iakoubova OA, Tong CH, Rowland CM, Kirchgessner TG, Young BA, Arellano R, Shiffman D, et al. Association of the Trp719Arg polymorphism in kinesin-like protein 6 with myocardial infarction and coronary heart disease in two prospective studies: The Cholesterol and Recurrent Events Study (CARE) and the West of Scotland Coronary Prevention Study (WOSCOPS) J Am Coll Cardiol. 2008; 51: 435– 43.

  10. García Matheus J C* Factores asociados a fibrinólisis fallida con estreptoquinasa pos infarto agudo de miocardio. Revista Peruana de Cardiología [Internet]2007[citado 10 nov 2009]:[aprox.29p.]

  11. Negrín Expósito JE, Fernández-Britto JE, Rodríguez JA, Castillo Herrera G, Senra Armas Á et al. Factores de riesgo, manifestaciones clínicas y tratamiento insuficiencia cardiaca en mayores de 65 años Rev Cub Invest Biomed [Internet]2007[citado 10 nov 2009];26(2).

  12. Kennedy JW. Recent changes in the care of acute myocardial infarction: implications for the emergency care physician. J Am Coll Cardiol 1988; 11: 446-9.

  13. García-García C, Recasensa Ll, Casanovasa N, Miranda F, Del Bañob F, Manresac JM et al. Reducción del tiempo puerta-aguja a los objetivos recomendados en las guías clínicas. Pronóstico a 1 año de seguimiento. Rev Esp Cardiol [Internet]2008[citado 10 nov 2009];61:[aprox.38p

  14. Samani NJ, Erdmann J, Hall AS, Hengstenberg C, Mangino M, Mayer B, Dixon RJ, et al. Genome-wide association analysis of coronary artery disease. N Engl J Med. 2007; 357: 443–53.

  15. Greco CA. Más riesgos, menos tratamiento: la paradoja de los pacientes ancianos con síndromes coronarios agudos. En: Científica SL, editor. Trabajos Distinguidos (Serie Cardiología). 14 ed. Buenos Aires; 2005.: Consultado: 10/11/2009.

  16. Mosterd A, Hoes AW, Bruyne MC de, Deckers JW, Linker DT, Hofman A, et al. Prevalence of heart failure and left ventricular dysfunction in the general population: The Rotterdam Study. Eur Heart J 2004; 20:447-55.

  17. Ho CY, Seidman CE. A contemporary approach to hypertrophic cardiomyopathy. Circulation. 2006; 113: e858–e62.

  18. Sen-Chowdhry S, Syrris P, Ward D, Asimaki A, Sevdalis E, McKenna WJ. Clinical and genetic characterization of families with arrhythmogenic right ventricular dysplasia/cardiomyopathy provides novel insights into patterns of disease expression. Circulation. 2007; 115: 1710–20.

  19. Antman EM, Anbe DT, Amstrong PW, Bates ER, Green LE, Hand M, et al. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction. Circulation. 2005; 110: 588-636.

  20. Arntz H-R, Bossaert L, Filippatos GS. European Resuscitation Council Guidelines for Resuscitation 2005. Section 5. Initial management of acute coronary syndromes. Resuscitation. 2005; 67S1: S87-S96.

  21. Bax L, Algra A, Mali WP, Edlinger M, Beutler JJ, van der Graaf Y (2008). «Renal function as a risk indicator for cardiovascular events in 3216 patients with manifest arterial disease». Atherosclerosis. DOI:10.1016/j.atherosclerosis.2007.12.006. PMID 18241872

  22. Alonso Martín JJ, Curcio Ruigómez A, Cristóbal Varela C, Tarin Vicente N, Serrano Antolín JA, Talavera, et al. Indicaciones de revascularización: aspectos clínicos. Rev Esp Cardiol. 2005; 58: 198-216.

  23. Hom T, Haase N, Rosamend W, Howard VJ, Rumsfeld J, Manolio T, et al. Heart disease and stroke statistics--2006 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2006; 113 (6): 85-151.

  24. Rivero Truit F, Castro Gutiérrez N, Galindo Portuondo E, Rodríguez J. Cardiopatía Isquémica y sus factores de riesgo. Archivo Médico de Camagüey[Internet]2005[citado 10 nov 2009];9(1):[aprox.29p

  25. Valladares Carvajal FJ de, Falcón Hernández A, Jorrín Román FR, García Rivas JE. Guía de práctica clínica para el infarto agudo de miocardio. Medisur[Internet]2009[citado 10 nov 2009];7(1):[aprox.29p.]

  26. González Vega FB, Martínez Pérez R, Martínez Rodríguez V. Clase killip y Kimball y tratamiento trombolítico en el adulto mayor. Revista de Ciencias Médicas la Habana[Internet]2007[citado 10 nov 2009];13(2):[aprox. 27p

  27. Menotti A, Lanti M. Twenty–five year cardiovascular disease incidence among middle –aged men. Disease burden, time shape, predictors, risk probabilities 2005; 1(11):749-57.

  28. Manso Fernández RT, Valladares Carvajal F, González Rodríguez C, Iraola Ferrer MD. Resultados del tratamiento trombolítico con estreptoquinasa recombinante en pacientes ancianos y no ancianos.[Internet]2005[citado 10 nov 2009];3(1):[aprox.29p.]

  29. Weaver WD. Fort he National Registry of Myocardial Infarction Investigator. Factors influencing the time to hospital administration of thrombolytic therapy: results from a large national registry (Abstract). Circulation2003; 86 (suppl I):60.

  30. Comité de Cardiopatía Isquémica de la Federación Argentina de Cardiología. Registro Nacional de Infarto Agudo al Miocardio de la Federación Argentina de Cardiología. Rev Fed Arg Cardiol 2004; 33: 127-31.

  31. Sabatine MS, Poughman L, Simonsen KL, Iakoubova OA, Kirchgessner TG, Ranade K, Tsuchihashi Z,.Association between ADAMTS1 matrix metalloproteinase gene variation, coronary heart disease and, benefit of statin therapy. Arterioscler Thromb Vasc Biol. 2008; 28: 562–567.

  32. Samani NJ, Erdmann J, Hall AS, Hengstenberg C, Mangino M, Mayer B, Dixon RJ, et al. Genome-wide association analysis of coronary artery disease. N Engl J Med. 2007; 357: 443–53.

  33. Greco CA. Más riesgos, menos tratamiento: la paradoja de los pacientes ancianos con síndromes coronarios agudos. En: Científica SL, editor. Trabajos Distinguidos (Serie Cardiología). 14 ed. Buenos Aires; 2005.: Consultado: 10/11/2009.

  34. Karvounis HI, Papadopoulos CE, Ketikoglou DG, Zaglavara TA, Parharidis GE, Louridas GE. Usefulness of low-dose dobutamine stress echocardiography for the evaluation of spontaneous recovery of stunned myocardium in patients with acute right ventricular infarction. J Am Soc Echocardiogr. 2005;18: 51-6.

  35. Valdesuso Aguila M, Hidalgo Barrios C, Dr. León Díaz R, Pérez A. Tratamiento prehospitalario del infarto agudo del miocardio. Instituto de Cardiología y Cirugía Cardiovascular. Rev Cubana Cardiol Cir Cardiovas 1997; 11(1): 20-8.

  36. Gerh B. Optimalmanagemrt of acute myocardial infaction at the dawn of the next milleniun Am Hear J 2003; 138

  37. Thune JJ, Hoefsten DE, Lindholm MG, Mortensen LS, Andersen HR, Nielsen TT, Kober L. Simple risk stratification at admission to identify patients with reduced mortality from primary angioplasty. Circulation 2005; 112: 2017-21.

  38. Kastrati A, Dibra A, Spaulding CH, Laarman GJ, Menichelli M, Valgimigli M et al. Meta-analysis of randomized trials on drug-eluting stents vs bare-metal stents in patients with acute myocardial infarction. Eur Heart J 2007; 28: 2706

  39. Rodríguez Gómez R, López de Castro García O, Jiménez Rafuls L, Gómez Maciñeira I, Castellano Becerril F. Infarto agudo del miocardio. Estudio de un año. Gaceta Médica Espirituana [Internet] 2007[citado 10 nov 2009]; 9(1):[aprox.29p.].

  40. Leal MF, Stadler NF, Souza Filho NFS, Haggi Filho H, Klsoviski ER, Munhoz EC. Acute myocardial infarction in elderly patients: comparative analysis of the predictors of mortality: the elderly versus young. Arq Bras Cardiol. 2002; 79 (4): 369-74.

  41. Bassan R, Potsch A, Pimenta L, Tachibana V, Souza A, Migon H, et al. Mortalidade hospitalar no infarto agudo do miocárdio: é possível prever utilizando dados de admissão? Arq Bras Cardiol. 1996; 67 (3): 149-58.

  42. Ribeiro DGL, Andrade PJN, Paes Júnior NJ, Saraiva LR. Infarto agudo do miocárdio: preditores de mortalidade em hospital público em Fortaleza, Ceará. Arq Bras Cardiol. 2003; 80 (6): 607-13.

  43. Kawakami N, Haratoni T. Epidemiology of job stress and health in Japan: Review of current evidence and future direction. Ind Health 2005; 37(2):174-86.

  44. Ortigosa AsoJ; Silva Melchor L. Estrategias de reperfusión en el infarto agudo. Servicio de Cardiología. Hospital Puerta de Hierro. Madrid. España. Rev Esp Cardiol 2008; 61: 6 – 9.

  45. Granger CB, Goldberg RJ, Dabbous O, Pieper KS, Eagle KA, Cannon CP, et al. Predictors of hospital mortality in the Global Registry of Acute Coronary Events. Global Registry of Acute Coronary Events Investigators. Arch Intern Med. 2003; 163 (19): 2345-53.

  46. Escosteguy CC, Portela MC, Medronho RA, Vasconcellos MTL. Infarto agudo do miocárdio: perfil clínico-epidemiológico e fatores associados ao óbito hospitalar no município do Rio de Janeiro. Arq Bras Cardiol. 2003; 80 (6): 593-9.

  47. Ramos PrevézO, Armaignac G, Nápoles D, Echevarria JC Trombólisis e infarto del miocardio agudo en unidad de cuidados Intensivos MEDISAN 2000; 4 (2):22-28.




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