Type 2 Myocardial Infarction and Long-Term Mortality Risk Factors: A Retrospective Cohort Study.
Acute cardiovascular events
BNP
Cardiovascular outcomes
Troponin
Type 2 myocardial infarction
Journal
Advances in therapy
ISSN: 1865-8652
Titre abrégé: Adv Ther
Pays: United States
ID NLM: 8611864
Informations de publication
Date de publication:
05 2023
05 2023
Historique:
received:
08
01
2023
accepted:
24
02
2023
medline:
17
5
2023
pubmed:
6
4
2023
entrez:
5
4
2023
Statut:
ppublish
Résumé
In-hospital risk factors for type 1 myocardial infarction (MI) have been extensively investigated, but risk factors for type 2 MI are still emerging. Moreover, type 2 MI remains an underdiagnosed and under-researched condition. Our aim was to assess survival rates after type 2 MI and to analyze the risk factors for patient prognosis after hospitalization. We conducted a retrospective database analysis of patients with MI diagnosis who were treated in Vilnius University Hospital Santaros Klinikos. A total of 6495 patients with the diagnosis of MI were screened. The primary study endpoint was long-term all-cause mortality. The predictive value of laboratory tests was estimated including blood hemoglobin, D dimer, creatinine, brain natriuretic peptide (BNP), C-reactive protein (CRP), and troponin levels. Out of all the patients diagnosed with MI there were 129 cases of type 2 MI (1.98%). Death rate almost doubled from 19.4% at 6 months to 36.4% after 2 years of follow-up. Higher age and impaired kidney function were risk factors for death both during hospitalization and after 2 years of follow-up. Lower hemoglobin (116.6 vs. 98.9 g/L), higher creatinine (90 vs. 161.9 μmol/L), higher CRP (31.4 vs. 63.3 mg/l), BNP (707.9 vs. 2999.3 ng/L), and lower left ventricle ejection fraction were all predictors of worse survival after 2 years of follow-up. Preventive medication during hospitalization can decrease the mortality risk: angiotensin-converting enzyme inhibitor (ACEi) (HR 0.485, 95% CI 0.286-0.820) and statins (HR 0.549, 95% CI 0.335-0.900). No significant influence was found for beta blockers (HR 0.662, 95% CI 0.371-1.181) or aspirin (HR 0.901, 95% CI 0.527-1.539). There is significant underdiagnosis of type 2 MI (1.98% out of all MIs). If the patient is prescribed a preventive medication like ACEi or statins, the mortality risk is lower. Increased awareness of elevation of laboratory results could help to improve the treatment of these patients and identify the most vulnerable groups.
Identifiants
pubmed: 37017913
doi: 10.1007/s12325-023-02485-2
pii: 10.1007/s12325-023-02485-2
doi:
Substances chimiques
Hydroxymethylglutaryl-CoA Reductase Inhibitors
0
Creatinine
AYI8EX34EU
C-Reactive Protein
9007-41-4
Natriuretic Peptide, Brain
114471-18-0
Angiotensin-Converting Enzyme Inhibitors
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Pagination
2471-2480Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer Healthcare Ltd., part of Springer Nature.
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