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The Korean Journal of Medicine 2009;77(6): 723-733.
급성 심근경색증 환자의 입원 중 합병증과 1년간 임상경과의 예측인자
윤현주, 정명호, 김계훈, 박근호, 심두선, 박형욱, 윤남식, 홍영준, 김주한, 안영근, 조정관, 박종춘, 강정채
Predictors of in-hospital complications and one-year clinical events in patients with acute myocardial infarction
Hyun-Ju Yoon, Myung Ho Jeong, Kye Hun Kim, Keun Ho Park, Doo Sun Sim, Hyung Wook Park, Nam Sik Yoon, Young Joon Hong, Ju Han Kim, Youngkeun Ahn, Jeong Gwan Cho, Jong Chun Park, Jung Chaee Kang
ABSTRACT
Background/Aims:
This study evaluated the predictors of in-hospital early complications and 1-year clinical events in patients with acute myocardial infarction (AMI).
Methods:
A total of 1,000 consecutive patients (63.4±12 years, 705 males) with AMI were divided into two groups according to the presence of in-hospital events (IHE): group I had IHEs (n=175, 65.6±12 years, 115 males), and group II had no events (n=825, 62.8±12 years, 590 males). IHE included death, cardiogenic shock, pacemaker implantation, ventricular arrhythmia, and mechanical ventilation.
Results:
The levels of glucose, creatinine, maximal creatine kinase (CK), troponin-I, hs-CRP, and NT-proBNP were higher in group I than in group II. Increased left ventricular dimension, a low ejection fraction, mitral regurgitation (MR), diastolic dysfunction, and a high wall motion score index were more common in group I compared with group II. The initial Killip class, ST-elevation AMI, and high levels of glucose, creatinine, CK-MB, troponin I, hs-CRP, NT-proBNP, and MR were significant independent predictors of IHE on multivariate analysis. During the 1-year follow-up, the major adverse cardiac event (MACE) rate was higher in group I than in group II. IHE, especially cardiopulmonary resuscitation, cardiogenic shock, and respiratory failure, were independent predictors of MACE during the 1-year clinical follow-up.
Conclusions:
High levels of glucose, creatinine, CK-MB, troponin I, hs-CRP, NT-proBNP, and MR were predictors of IHE, and the 1-year MACE-free survival was lower in AMI patients with IHE.
Keywords: Myocardial infarction; Mortality; Prognosis
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