Risk factors and predictors of hospital complications of myocardial infarction in young patients
TL;DR
Risk factors and predictors associated with the development of life-threatening complications and the progression of heart failure during the hospital stage of treatment in young patients with ST-segment elevation myocardial infarction have been developed.
Abstract
To identify risk factors and predictors of hospital complications of myocardial infarction in young patients. Materials and Methods . The prospective study included 130 young patients aged 18 to 44 years with ST-segment elevation myocardial infarction who underwent endovascular revascularization. The average age was 38.9 ± 5.4 years. All patients included in the prospective study underwent conventional clinical, instrumental, and laboratory examinations, which included the collection of anamnestic data, physical examinations, and a set of laboratory tests, including high-sensitivity troponin I (TnI), complete blood count, biochemical blood test, and N-terminal fragment of brain natriuretic peptide (NT-pro-BNP). Patients underwent echocardiography and coronary angiography. Contrast-enhanced cardiac magnetic resonance imaging was performed 3–5 days after the endovascular intervention. Results . Factors associated with the development of life-threatening complications at the hospital stage of treatment in young patients with MI were: pre-revascularization TIMI flow grade 0–1; thrombosis of the proximal segment of the left anterior descending artery; absence of collateral circulation and intermediate coronary stenoses, time to reperfusion, Killip class III–IV heart failure. Risk factors and predictors of hospital heart failure development in young patients were: the time interval from the onset of pain syndrome to reperfusion; the presence of microvascular obstruction and intramyocardial hemorrhage on MRI; smoking; multivessel coronary artery disease, and CKD. The NT-proBNP level and the peak troponin I level were independent predictors of all complications during the hospital stage of treatment. Conclusion . Risk factors and predictors associated with the development of life-threatening complications and the progression of heart failure during the hospital stage of treatment in young patients with ST-segment elevation myocardial infarction have been developed.