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KMID : 0882420090770060723
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Korean Journal of Medicine
2009 Volume.77 No. 6 p.723 ~ p.733
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Predictors of in-hospital complications and one-year clinical events in patients with acute myocardial infarction
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Yoon Hyun-Ju
Kim Kye-Hun
Jeong Myung-Ho
Cho Jeong-Gwan
Park Jong-Chun
Kang Jung-Chaee
Park Hyung-Wook
Hong Young-Joon
Kim Ju-Han
Yoon Nam-Sik
Ahn Young-Keun
Park Keun-Ho
Sim Doo-Sun
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Abstract
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Background/Aims: This study evaluated the predictors of in-hospital early complications and 1-year clinical events in patients with acute myocardial infarction (AMI).
Methods: A total of 1,000 consecutive patients (63.4±12 years, 705 males) with AMI were divided into two groups according to the presence of in-hospital events (IHE): group I had IHEs (n=175, 65.6±12 years, 115 males), and group II had no events (n=825, 62.8±12 years, 590 males). IHE included death, cardiogenic shock, pacemaker implantation, ventricular arrhythmia, and mechanical ventilation.
Results: The levels of glucose, creatinine, maximal creatine kinase (CK), troponin-I, hs-CRP, and NT-proBNP were higher in group I than in group II. Increased left ventricular dimension, a low ejection fraction, mitral regurgitation (MR), diastolic dysfunction, and a high wall motion score index were more common in group I compared with group II. The initial Killip class, ST-elevation AMI, and high levels of glucose, creatinine, CK-MB, troponin I, hs-CRP, NT-proBNP, and MR were significant independent predictors of IHE on multivariate analysis. During the 1-year follow-up, the major adverse cardiac event (MACE) rate was higher in group I than in group II. IHE, especially cardiopulmonary resuscitation, cardiogenic shock, and respiratory failure, were independent predictors of MACE during the 1-year clinical follow-up.
Conclusions: High levels of glucose, creatinine, CK-MB, troponin I, hs-CRP, NT-proBNP, and MR were predictors of IHE, and the 1-year MACE-free survival was lower in AMI patients with IHE.
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KEYWORD
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Myocardial infarction, Mortality, Prognosis
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