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Factors associated with the risk of death and hospitalization in recurrent myocar-98 dial infarction

Authors: Sedykh D.Yu. 1 3, Gorbunova E.V. 1 3, Zykov M. V. 1, Kashtalap V. V. 1 2, Barbarash O.L. 1 2

Company: 1 Research Institute for Complex Issues of Cardiovascular Diseases, Sosnovyy bul’var, 6, Kemerovo, 650002, Russian Federation;
2 Kemerovo State Medical University of Ministry of Health of the Russian Federation, ulitsa Voroshilova, 22A, Kemerovo, 650029, Russian Federation;
3 Kemerovo Regional Clinical Cardiology Dispensary named after academician L.S. Barbarash, Sosnovyy bul’var, 6, Kemerovo, 650002, Russian Federation

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Type:  Ischemic heart disease


DOI: https://doi.org/10.24022/1997-3187-2017-11-2-98-108

For citation: Sedykh D.Yu., Gorbunova E.V., Zykov M.V., Kashtalap V.V., Barbarash O.L. Factors associated with the risk of death and hospitalization in recurrent myocardial infarction. Kreativnaya kardiologiya (Creative Cardiology, Russian journal). 2017; 11 (2): 98—108 (in Russ.). DOI: http://dx.doi.org/10.24022/1997-3187-2017-11-2-98-108

Keywords: recurrent coronary events myocardial infarction polyvascular disease percutaneous coronary intervention adherence to pharmacotherapy

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Abstract

Objective. To identify the independent prognostic factors associated with the development of recurrent fatal and nonfatal myocardial infarction (MI).

Material and methods. Based on the database of acute coronary syndrome (ACS) registry in 2009 in Kemerovo Regional Clinical Cardiology Dispensary named after academician L.S. Barbarash 471 patients with primary MI were included into the retro-prospective study. Within 5 years we had been evaluating the endpoints in regard to the development of fatal and nonfatal recurrent MI in order to reveal their independent predictors. All patients were divided into two groups. The first group of people included 346 patients without the diagnosis of RMI, the second - 125 patients with RMI.

Results. During the 5-year observation period the cases of recurrent coronary events are detected: unstable angina was revealed in 126 patients (26.7%) and recurrent MI — in 125 patients (26.5%), fatal MI was detected in 23 (18.4%) of them. The independent predictors of the development of a fatal and nonfatal recurrent MI are: non-Q-wave type of primary MI (odds ratio (OR) 4.012; 95% confidence interval (CI) 2.750—5.853; р = 0.0000), nonexecution of a percutaneous coronary intervention (PCI) at the moment of the primary MI (OR 0.250; 95% CI 0.170—0.366; р = 0.0000), manifestations of polyvascular disease (PolyVD) in the form of cerebral atherosclerosis and atherosclerosis of lower extremity arteries at the moment of inclusion into the registry (OR 2.340; 95% CI 1.343—4.077; р = 0.0030) and the signs of complicated course of primary MI in the form of acute heart failure (AHF) Killip II—IV (OR 2.040; 95% CI 1.174—3.545; р = 0.0011). The factors associated with fatal outcomes of a recurrent myocardial infarction are: age older than 57.7 years (OR 1.053; 95% CI 1.002—1.107; р = 0.042), detection of PolyVD (OR 2.916; 95% CI 0.963—8.833; р = 0.0580) and non-execution of PCI during initial hospitalization (OR 0.253; 95% CI 0.111—0.577; р = 0.0010).

Gonclusion. The detection of predictors of adverse events in patients with primary MI allows to purposefully enhance the therapeutic and preventive measures and to reduce the risk of recurrent cardiovascular events.

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About Authors

  • Sedykh D.Yu., http://orcid.org/0000-0001-7058-2008

  • Gorbunova E.V., http://orcid.org/0000-0002-2327-2637

  • Zykov M.V., http://orcid.org/0000-0003-0954-9270

  • Kashtalap V.V., http://orcid.org/0000-0003-3729-616X

  • Barbarash O.L., http://orcid.org/0000-0002-4642-3610

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


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