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Predicting the development of cardiogenic shock in myocardial infarction
I Sukmanova1
,
OST Olga Tanana1
,
1Altay region cardiologist hospilal, acute infarction - Barnaul - Russian Federation
,
Topic(s): Acute heart failure (other)
Citation:
European Journal of Heart Failure Abstracts Supplement
(
2016
)
18
(
Supplement 1
),
132
Purpose: to develop a mathematical formula to calculate the risk of developing cardiogenic shock in patients with AMI. Methods: we examined 55 patients with mi aged 56-85 years. The first group consisted of 29 patients (14 men and 15 women) at the age of 66,8 ± 1.2 years, complicated by cardiogenic shock, second - 26 patients (15 men and 11 women) at the age of 66,4 ± 1,0 years without cardiogenic shock. All admission underwent standard laboratory tests with dynamic assessment of the level of troponin I, D-dimer. Repeatedly recorded 12-lead ECG was performed the echocardiography, the coronary angiography on the unit of General Electric, was measured central hemodynamic parameters. The Results: Patients in compared groups were matched for age, both groups were dominated by men. In the first and second groups of more than 60% of patients with IMPT (at 65.5% and 61.5%, respectively, p < 0.05). Patients with back, they were almost 2 times more in the 1st group (CABG) than in the second (10 (34,4%), against 5(19,2%), with 2/3 of them involved the right ventricle. More than 60% (62,2%) patients in the CABG group and 61.5% in the group without CABG was performed revascularization ISA. The "symptom-balloon" in the group with CABG when INT was 2 times longer and amounted to 420 minutes than in those without CABG (210, p < 0.05), which was an important factor determining the development of complications. Thrombolytic therapy is carried out 10 (52,6%) patients with INT in the 1st group and 6 (37,5%) patients of the second group. PCI completed 18(62%) patients of the first group and 14(53.8 percent) in the second. Pharmacoinvasive strategy (TLT + PCI) due to non-delivery of the patient in the first 120 minutes were used in 5(27,2%) patients of the first group and 4(15.4 %) second. Most patients of the 1st group, they developed in the first day, admission CABG were signs in 8(27.5%) patients. The garden in the first group at admission was less than during the second (96.5 % against 138.4, p < 0.01). To predict the development of shock on the obtained data was applied stepwise discriminant analysis selected the most important predictors of the development of CABG. For these factors amounted to equations linear discriminating functions for each group. To predict outcome in new patients of the equation 2 is calculated: Shock(+) = -308,4 + 0,22*AD(p) + 4,47*Sat + 0,44*GFR - 0,32*Troponin + 0,61*Creatinine - 0,0011* income + 6,37* Potassium + 0,37* Glucose + 0,32* Hemoglobin; Shock(-) = -288,0 + 0,16*AD(p) + 4,21*Sat + 0,49*GFR - 0,22*Troponin + 0,66*Creatinine - 0,0014* income + 7,66* Potassium + 0,28* Glucose + 0,29* Hemoglobin. Each patient can be assigned to the group corresponding to the maximum value of the function, with a probability of 83.6 per cent. Conclusions: Thus, a multivariate mathematical model based on the method of discriminant analysis to predict the development of shock.
