The main factors, influencing the hospital outcomes and long-term prognosis in latecomers with myocardial infarction with ST elevation

Authors: Makarycheva O.V., Konovalova E.V., Luk’yanova Yu.V., Grachev S.P., Vasilieva E.Yu., Shpektor A.V.

Company: 1 Moscow State University of Medicine and Dentistry, ulitsa Delegatskaya, 20/1, Moscow, 127473, Russian Federation
2 Davydovskiy City Hospital of Moscow Department of Health, ulitsa Yauzskaya, 11, Moscow, 109240, Russian Federation

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Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2020-14-3-224-232

For citation: Makarycheva O.V., Konovalov E.V., Lukyanova Yu.V., Grachev S.P., Vasilieva E.Yu., Shpektor A.V. The main factors, influencing the hospital outcomes and long-term prognosis in latecomers with myocardial infarction with ST elevation. Creative Cardiology. 2020; 14 (3): 224–32 (in Russ.). DOI: 10.24022/ 1997-3187-2020-14-3-224-232

Received / Accepted:  15.09.2020 / 25.09.2020

Keywords: latecomers myocardial infarction revascularization prognosis

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Abstract

About 13–15% patients with STEMI admit at hospital later than 48 hours from the symptoms onset, but the optimal treatment strategy in these cases remains unclear.

Aim. We evaluated the influence of different risk factors and the choice of invasive or conservative treatment on inhospital outcomes and long-term prognosis in these cases.

Material and methods. Retrospective analysis of data of patients with myocardial infarction with ST n-elevation (STEMI) hospitalized later than 48 hours of symptoms onset was evaluated. Of the patients, 90 underwent PCI and 109 were treated conservatively. Survival status after 5 years is known in 116 patients included in the study.

Results. The age (р=0.036) and reduced injection fraction (EF) of left ventricular (р=0.024) independently correlated with poor inhospital prognosis. Smoking had a negative correlation with inhospital mortality in latecomers with STEMI (p=0.044). The multivariate analysis didn't show the independent influence of revascularization on inhospital outcomes. Age and reduced EF were also independed predictors that increased risk of 5-year mortality (p=0.009 for age and 0.006 for reduced EF). Independent negative correlation between revascularization and long-term mortality (р=0.047) was found.

Conclusion. The independed predictors that increased risk of in-hospital and long-term mortality in patients with STEMI admitted in hospital after 48 hours from the symptoms onset were age and reduced EF. The independed influence of revascularization after 48 hours from symptoms onset on improved long-term survival was found in latecomers with STEMI.

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About Authors

  • Makarycheva Oksana Vadimovna, Cand. Med. Sc., Аssociate Professor of Chair of Cardiology, ORCID
  • Konovalova Elena Vasil'evna, Cand. Med. Sc., Assistant Professor of Chair of Cardiology, ORCID
  • Luk'yanova Yuliya Vital'evna, Cand. Med. Sc., Cardiologist, ORCID
  • Grachev Sergey Petrovich, Dr. Med. Sc., Professor, ORCID
  • Vasilieva Elena Yur'evna, Dr. Med. Sc., Professor, Chief of the Сenter of Atherothombosis, Сhief Physician of Davydovskiy City Hospital of Moscow Department of Health, ORCID
  • Shpektor Aleksandr Vadimovich, Dr. Med. Sc., Professor, Corresponding Member of Russian Academy of Sciences, Chief of Chair of Cardiology, ORCID

Chief Editor

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