Major adverse cardiac and cerebrovascular events and organ supportive measures Circulatory System
Conditions
Interventions
A retrospective observational study was conducted on 607 patients admitted to the critical care department at Cairo University Hospitals with ST-elevation myocardial infarction from 2013 to 2017. They
Sponsors
Cairo University
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Patients diagnosed with acute STEMI. Acute myocardial infarction was diagnosed upon detection of a rise and/or fall of cardiac biomarkers (preferably troponin) with at least one value above 99th percentile of the upper reference limit, together with evidence of myocardial ischemia with at least one of the following: symptoms of ischemia, ECG changes, development of pathological Q waves in ECG, or imaging evidence of new loss of viable myocardium or new regional wall motion abnormality. ECG criteria were based on changes in electrical currents of the heart (measured in millivolts). Typically, ST-segment elevation in acute myocardial infarction, measured at the J point, should be found in two contiguous leads and be =0.25 mV in men below the age of 40 years, =0.2 mV in men over the age of 40 years, or =0.15 mV in women in leads V2–V3 and/or =0.1 mV in other leads (in the absence of left ventricular (LV) hypertrophy or left bundle branch block (LBBB). In patients with inferior myocardial infarction, it is advisable to record right precordial leads (V3R and V4R) seeking ST elevation, in order to identify concomitant right ventricular infarction. Likewise, ST-segment depression in leads V1–V3 suggests myocardial ischemia, especially when the terminal T-wave is positive (ST-elevation equivalent) and may be confirmed by concomitant ST elevation =0.1 mV recorded in leads V7–V9.
Exclusion criteria
Exclusion criteria: 1. Patients with evidence of an acute or chronic infection, hematological diseases, history of trauma or surgical operation within preceding 2 weeks 2. Patients diagnosed with immune system deficiencies, malignancies, autoimmune disorders or on immunosuppressive regimens including steroids
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Major adverse cardiac and cerebrovascular events (MACCE) including death, myocardial infarction, stroke or target vessel revascularization. They were recorded during patient in-hospital stay through verifying medical records, laboratory values, ECG records and possible 2nd look angiograms. This was done during patient in-hospital course. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Organ supportive measures including patients who needed: 1.1. Respiratory support (invasive and non-invasive) 1.2. Hemodynamic support (vasopressors for persistent hypoperfusion state or mechanical assistance e.g. intra-aortic balloon pulsation) 1.3. Renal replacement therapy (dialysis for acute renal failure) Collected through reviewing electronic records and vital signs sheets recorded during the whole hospital stay | — |
Countries
Egypt
Outcome results
None listed