Naslov
Symptom of dyspnea among all-comers admitted for acute myocardial infarction is an independent and powerful predictor of poor in-hospital outcomes

Autori
Borovac, Josip Anđelo ; Mikačić, Marijana ; Mirić, Dino ; Glavaš, Duška

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, prošireni sažetak, znanstveni

Skup
Heart Failure & World Congress on Acute Heart Failure 2023

Mjesto i datum
Prag, Češka Republika, 20.05.2023. - 23.05.2023

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
heart failure ; acute myocardial infarction ; dyspnea ; prognosis ; death ; resuscitated cardiac arrest ; symptoms ; NSTEMI ; STEMI

Sažetak
Background: It was previously demonstrated that patients hospitalized for acute coronary syndrome (ACS) and presenting with symptoms of dyspnea without evident signs of heart failure may have worse short-term and long-term mortality, compared to patients without dyspnea. Purpose: We sought to determine whether the symptom of dyspnea among all-comers admitted for acute myocardial infarction (AMI) would be independently associated with worse in-hospital outcomes. Methods: A total of 202 consecutive patients admitted for AMI to the Emergency Department (ED) during 2019-2020 were analyzed. The primary endpoint of interest was a composite outcome consisting of in-hospital death and resuscitated cardiac arrest. Results: The mean age of enrolled patients was 65±12 years and 32.2% were women (N=65). More than half of patients presenting with ST-elevation myocardial infarction (STEMI, 58.9%) while 41.1% presented with non-ST-elevation myocardial infarction (NSTEMI). About a quarter of patients (25.7%, N=52) with AMI presented with the dominant symptom of dyspnea. The baseline characteristics of the analyzed cohort are shown in Figure 1. The rate of the primary outcome was 4.5% (N=9) in the total population. Patients presenting with dyspnea had a significantly higher rate of primary outcome compared to those without dyspnea (13.5% vs. 1.3%, p<0.001 ; Figure 2). In the multivariable regression model, dyspnea at ED presentation was an independent predictor of the primary outcome in patients with AMI (OR 9.1, 95% CI 1.33-63, p=0.002), even after stepwise adjustment for multiple baseline covariates including age, sex, AMI type, diabetes mellitus, hypertension, atrial fibrillation, systolic blood pressure at admission, receipt of emergent PCI, and laboratory values at admission (C-reactive protein, creatinine, and high-sensitivity cardiac troponin I). Conclusions: Symptom of dyspnea among consecutive all-comers with AMI is an independent and powerful predictor of adverse hospital events as it was associated with a 9-fold increase in the likelihood of the primary outcome. This association was independent of relevant clinical, biochemical, and anthropometric variables. Therefore, dyspnea should be regarded as a high-risk indicator of potential clinical deterioration and poor sequelae among all-comers with AMI.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

Napomena
Annual Congress of the Heart Failure Association of the ESC.

POVEZANOST RADA