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Risk Stratification After Acute Myocardial
Infarction in the Intensive Care Unit.

Santos, Moisés; Rodríguez, Belkys;
Iraola, Marcos

University Hospital "Dr. Gustavo Aldereguía Lima". Cienfuegos. Cuba

Introduction: Many published studies have shown the value of different variables to identify risk in patients with Acute Myocardial Infarction (AMI). There is a relation between prognosis, stay and management of these and it depends of the risk of death or complications.

Objectives: To analyze the behavior of some risk parameters (RP) and their power in the prediction of High Risk (HR) or Low Risk (LR) in the prognosis and to propose an intervention to modify stay in the Intensive Care Unit (ICU).

Material and Methods: All the patients admitted in the ICU with diagnosis of AMI were included in two groups: Group I (between March 1st to May 31 of 1999 and Group II (between October 1st to December 31 of 1999). Both groups were evaluated with 13 parameters. These groups were compared and an intervention in stay was made in Group II. Relative risk (RR) was calculated to evaluate the association power of the RP with mortality. Table 1.

Results: More HR patients than LR were found in both groups. Mortality was higher in HR patients and the RP associated with mortality were: cardiogenic shock (RR= 5.08, p<0.05), advanced atrioventricular block (RR=4.57, p<0.05), sustained tachycardia (RR=4.45, p<0.05), ventricular fibrillation (RR=3.18, p<0.05), maintained pain (RR=2.86, p<0.05), left ventricular dysfunction (RR=2.81, p<0.05) and patients excluded of thrombolysis (RR=2.38, p<0.05). The early ICU discharge for LR patients didn't¢t have deleterious effects.

Discussion: The cardiogenic shock, advanced atrioventricular block, sustained tachycardia, ventricular fibrillation, maintained pain, left ventricular disjunction and patients excluded from thrombolysis are variables that may have been taken in consideration in the risk stratification for AMI patients

Conclusions: RS helps us to predict better or worse outcomes in AMI patients and to develop strategies in the management. LR patients can be safely discharge early from the ICU.



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2nd Virtual Congress of Cardiology

Dr. Florencio Garófalo
Steering Committee
Dr. Raúl Bretal
Scientific Committee
Dr. Armando Pacher
Technical Committee - CETIFAC

Copyright© 1999-2001 Argentine Federation of Cardiology
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