29 May 2009
Major adverse cardiac event predictors in survivors of myocardial infarction with asymptomatic left ventricular dysfunction or chronic heart failureMarek KuchABDEF, Maciej JaniszewskiBDEF, Artur MamcarzADF, Agnieszka Cudnoch-JedrzejewskaBCE, Miroslaw DluzniewskiAG
Med Sci Monit 2009; 15(6): PH40-48 :: ID: 869660
Progress in the management of myocardial infarction has contributed to the increased population of patients with asymptomatic left ventricular dysfunction or congestive heart failure. These patients are at high risk of sudden cardiac death. Factors that worsen this prognosis include exacerbation of coronary artery disease and acute coronary syndrome. We aimed to define and compare risk factors of acute coronary syndrome and sudden cardiac death as well as the cumulative incidence of both in patients after myocardial infarction with asymptomatic left ventricular dysfunction or congestive heart failure during a 2-year follow-up period.
Material and Method
We enrolled 320 patients who survived the first 2 to 3 weeks after first ST-elevated myocardial infarction. Seventy-one patients who developed acute coronary syndrome and 38 who experienced sudden cardiac death were analyzed.
In patients with asymptomatic left ventricular dysfunction, the only independent predictor of sudden cardiac death was male sex. Diabetes was the only predictor for acute coronary syndrome. In patients with chronic heart failure, low heart-rate variability was the strongest independent predictor of sudden cardiac death. Increased mean 24-hour heart rate was the most powerful predictor of acute coronary syndrome. The cumulative incidence of acute coronary syndrome and sudden cardiac death was most strongly associated with a total cholesterol level >200 mg/dL and increased QT-interval dispersion.
Predictors of acute coronary syndrome and sudden cardiac death differ in patients after myocardial infarction with asymptomatic left ventricular dysfunction or chronic heart failure and are inconsistent at different stages of development of chronic heart failure.
Keywords: Poland - epidemiology, Myocardial Infarction - physiopathology, Multivariate Analysis, Models, Cardiovascular, Incidence, Heart Failure - physiopathology, Death, Sudden, Cardiac - epidemiology, Aged, 80 and over, Acute Coronary Syndrome - epidemiology, Survivors, Ventricular Dysfunction, Left - physiopathology
01 March 2023 : EditorialEditorial: Global Surveillance of Highly Pathogenic Avian Influenza Viruses in Poultry, Wild Birds, and Mammals to Prevent a Human Influenza Pandemic
Med Sci Monit 2023; 29:e939968
03 March 2023 : Database AnalysisReinfections from SARS-CoV-2: A Retrospective Study from the Gyncentrum Genetic Laboratory in Sosnowiec, Po...
Med Sci Monit In Press; DOI: 10.12659/MSM.939452
09 February 2023 : Clinical ResearchEvaluation of Health-Related Quality of Life and Mental Health in 729 Medical Students in Indonesia During ...
Med Sci Monit 2023; 29:e938892
19 January 2023 : Clinical ResearchDetermining the Impact of the COVID-19 Pandemic on Dental Care in the Serbian Adult Population: An Online Q...
Med Sci Monit 2023; 29:e939238
27 December 2022 : Clinical ResearchEffect of Physiotherapy to Correct Rounded Shoulder Posture in 30 Patients During the COVID-19 Pandemic in ...
Med Sci Monit 2022; 28:e938926
21 Mar 2023 : Clinical ResearchEfficacy of Direct Anterior Approach Versus Posterior Lateral Approach for Total Hip Replacement in Patient...
Med Sci Monit In Press; DOI: 10.12659/MSM.939682
21 Mar 2023 : Clinical ResearchIntraoperative Hypotension and Its Association with Postoperative Acute Kidney Injury in Patients Undergoin...
Med Sci Monit In Press; DOI: 10.12659/MSM.938945
20 Mar 2023 : Clinical ResearchManagement of Unstable C1 Fractures Involving the Lateral Mass: Posterior C1-C2 Screw-Rod Fixation and Fusion
Med Sci Monit In Press; DOI: 10.12659/MSM.938600
17 Mar 2023 : Clinical ResearchRelationship Between Autonomic Nervous System Activity and Axial Length in Children
Med Sci Monit In Press; DOI: 10.12659/MSM.939451
Most Viewed Current Articles
13 Nov 2021 : Clinical ResearchAcceptance of COVID-19 Vaccination and Its Associated Factors Among Cancer Patients Attending the Oncology ...
Med Sci Monit 2021; 27:e932788
30 Dec 2021 : Clinical ResearchRetrospective Study of Outcomes and Hospitalization Rates of Patients in Italy with a Confirmed Diagnosis o...
Med Sci Monit 2021; 27:e935379
08 Mar 2022 : Review articleA Review of the Potential Roles of Antioxidant and Anti-Inflammatory Pharmacological Approaches for the Man...
Med Sci Monit 2022; 28:e936292
01 Jan 2022 : EditorialEditorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...
Med Sci Monit 2022; 28:e935952