Clinical relevance of the association between myocardial injury and mortality in the acute patient
DOI:
https://doi.org/10.63600/ae0t1x70Keywords:
Myocardial injury, Mortality, PrognosisAbstract
Introduction:myocardial injury is strongly associated with mortality.Objectives:to evaluate the prevalence of myocardial injury and its association with mortality. Materials and Methods:prospective inclusion of 850 patients hospitalized in the Coronary Care Unit of the JFCabral Institute of Cardiology in Corrientes, Argentina, from January to February 2022. Were included 570 patients at study. Myocardial injury was present in 153 patients (26.84%). Causes of myocardial injury and their relationship with mortality were evaluated. Baseline and 3-hour troponin TnTus levels were measured. A multivariate model was constructed to identify variables associated with mortality.Results:the mean age was 67.20±14 years, and 67% were male(381 patients). The TnTus on admission was 137.36±242.9 ng/L, and at 3 hours it was 278.9±969 ng/L. The causes were: heart failure with preserved ejection fraction 19.7%(30 patients); heart failure with reduced ejection fraction 21.7%(33patients); pulmonary embolism 3.3%(5patients); pneumonia 3.3%(5patients); atrial fibrillation with flutter 6.6%(10 patients); moderate chronic kidney disease 11.8%(18patients); severe renal failure and/or on dialysis 13.2% (20patients); complete av block 5.3% (8patients); pulmonary embolism 5.3% (8patients); Takotsubo cardiomyopathy 2.6%(4patients); COVID-19 1.3%(2patients); pulmonary hypertension 1.3%(2patients); and severe aortic stenosis with TAVI 4.6%(7patients). Overall mortality was 1.8%, and with myocardial injury, it was 5.2% (8 patients). Predictors of mortality were: heart failure (HFrEF) OR=4.5(95% CI 2.1–7.8); age OR=1.2(95% CI 1.14–1.8);diabetes OR=1.4(95% CI 1.10–1.85); and myocardial injury OR=2.53(95% CI 1.5–4.3).Conclusions:myocardial injury was present in one out of every four patients hospitalized in the coronary care unit. Its presence increased hospital mortality and was an independent predictor of mortality, along with HFrEF, age, and diabetes.
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