Richa Agrawal, RK Nath, Neeraj Pandit, Ajay Raj
Heart India 2018 6(4):127-132
Background: Primary percutaneous coronary intervention (PCI) is the most effective therapy for managing acute ST-segment elevation myocardial infarction (STEMI). Studies have shown baseline low hemoglobin (Hb) and reduced creatinine clearance (CrCl) as risk factors for adverse outcomes in patients with heart failure, in patients undergoing PCI, and in acute coronary syndrome. However, their similar role in patients of acute STEMI undergoing primary PCI is not known. Objective: The main objective is to study whether baseline Hb and CrCl are the independent risk factors for the 30 days event rate in patients of acute STEMI undergoing primary PCI. Methods: We prospectively studied 500 patients of acute STEMI undergoing primary PCI. Hb and CrCl were measured at baseline and then at 15th and 30th day after the event. Patients were divided into four groups based on whether they have normal or abnormal baseline Hb and CrCl. Patients were followed for 30-day postdischarge for incidence of major adverse events in the form of death, reinfarction, reintervention, and hemodynamically unstable ventricular tachyarrhythmias. We assessed correlation between baseline Hb, CrC, l and 30-day event rate among four groups using Chi-square test. Results: On comparison among groups, compared to Group 1, Group 2, 3, and 4 had significantly higher adverse events ([6.48% vs. 19.44%] [P = 0.021]), ([6.48% vs. 30%] [P = 0.0003]), ([6.48% vs. 51.66%] [P ≤ 0.0001]), respectively, at 30 days after primary PCI. Conclusion: In patients of acute STEMI undergoing primary PCI, both baseline impaired CrCl and low Hb behaved independently as risk factors for increased 30-day event rates.
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