Relevancia clínica de la asociación entre injuria miocárdica y mortalidad en el paciente agudo
DOI:
https://doi.org/10.63600/ae0t1x70Palabras clave:
Injuria miocárdica, Mortalidad, PronósticoResumen
Introducción: la lesión miocárdica está fuertemente asociada con mortalidad. Objetivos: evaluar prevalencia de injuria miocárdica y su asociación con mortalidad. Material y Métodos: inclusión prospectiva de 850 pacientes hospitalizados en Unidad Coronaria del Instituto de Cardiología J F Cabral de Corrientes, desde el 04/01/2021 al 28/02/2022. Ingresaron al estudio 570 pacientes. La injuria miocárdica estuvo presente en 153 pacientes (26.84%). Se evaluó causas de injuria miocárdica y relación con mortalidad. Se doso TnTus basal y a 3 horas. Se construyó un modelo Multivariado para ver variables asociadas a mortalidad. Resultados: la edad media fue 67.20±14 años, 67% masculinos (381 ptes). La TnTus al ingreso fue 137.36±242.9 ng/L, a 3hs 278.9±969 ng/L. Las causas fueron IC preservada 19.7%(30ptes); IC con FE deteriorada 21.7%(33 ptes); 3,3% TEP(5ptes); 3.3% neumonía (5ptes); 6.6 % FA-Aleteo(10 ptes); IRC moderada 11.8%(18 ptes), fallo renal severo y/o en diálisis 13.2%(20 ptes); 5.3% BAVC(8 ptes); 5.3% TVS(8 ptes); 2.6% Tako Tsubo(4 ptes); 1.3 por COVID 19(2pte); 1,3% HTP(2 ptes), estenosis aortica severa con TAVI 4.6% (7 ptes). La mortalidad global fue 1.8%, y con injuria miocárdica 5.2%(8ptes). Los predictores de mortalidad fueron: IC con Fe deteriorada OR 4.5(IC 95% 2.1-7.8); edad OR 1.2(IC 95% 1.14-1.8), diabetes OR=1.4(IC 95% 1.10-1.85) e injuria miocárdica OR=2.53(IC 95% 1.5-4.3). Conclusiones: la injuria miocárdica estuvo presente en uno de cada 4 pacientes hospitalizados en Unidad coronaria, su presencia incremento la mortalidad hospitalaria y fue predictor independiente de mortalidad conjuntamente con IC con FE deteriorada, la edad y diabetes.
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