Clinical and biochemical parameters in patients with acute heart failure secondary to myocardial infarction
https://doi.org/10.21886/2712-8156-2022-3-1-60-66
Abstract
Objective: to study the clinical features, dynamics of the NTproBNP level in patients with STEMI, taking into account the risk of hospital mortality scales. Materials and methods: the study included 150 patients with STEMI. All patients were divided into subgroups: according to the GRACE scale (low, medium and high risk) and the degree of acute heart failure (AHF) classification T.Killip II and III-IV. The clinical and laboratory characteristics of patients, including the level of NTproBNP, were studied. Results: the average age of STEMI patients was 61.7±2.96 years. Dyslipidemia, increased level of markers of myocardial necrosis, high concentration of NTproBNP without tendencies to changes in the dynamics of hospital treatment were detected on the first day of STEMI. Patients with STEMI of Killip III-IV had a statistically significant NTproBNP level 2.0 times higher (p<0.05), and at discharge 2.1 times (p<0.05) compared with the group of patients with Killip II. It should be noted that during hospital treatment, the values of NTproBNP did not change statistically significantly regardless of the degree of T.Killip AHF (p>0.05). A high level of NTproBNP was obtained on the first day of the STEMI in all risk groups of hospital mortality on the GRACE scale. A tendency to increase the values of NTproBNP (p<0.05) with an increase in the risk of hospital mortality was revealed. Conclusion: patients with STEMI AHF Killip III-IV have a greater volume of myocardial damage and the level of NTproBNP, determining a high risk of heart failure. NTproBNP values progressively increase with increasing GRACE scale risk and will not change during inpatient treatment.
About the Authors
E. V. Khorolets
Rostov State Medical University
Russian Federation
Russian Federation
Ekaterina V. Khorolets - Cand. Sci. (Med.), Associate Professor of the Department of Therapy of Rostov State Medical University.
Rostov-on-Don.
M. K. Akhverdieva
Rostov State Medical University
Russian Federation
Russian Federation
Milana K. Akhverdieva - Cand. Sci. (Med.), Associate Professor of the Department of Therapy of the Rostov State Medical University.
Rostov-on-Don.
References
1. Искаков Е.Б. Эпидемиология сердечно-сосудистых заболеваний. Медицина и экология. 2017;2(83):19-28. eLIBRARY ID: 44026863.
2. Концевая А.В., Драпкина О.М., Баланова Ю.А., Имаева А.Э., Суворова Е.И., Худяков М.Б. Экономический ущерб сердечно-сосудистых заболеваний в Российской Федерации в 2016 году. Рациональная фармакотерапия в кардиологии. 2018;14(2):156-66. DOI: 10.20996/1819-6446201814-2-156-166.
3. Дюжева Е.В. Распространенность факторов риска сердечнососудистых заболеваний среди населения разных стран. Современные проблемы науки и образования. 2017;5:101. eLIBRARY ID: 30457904.
4. Бунова С.С., Усачева Е.В., Замахина О.В. Динамика заболеваемости инфарктом миокарда в регионах Российской Федерации за 11-летний период (2002-2012гг). Социальные аспекты здоровья населения. 2015;1:3. eLIBRARY ID: 23067242.
5. Самородская И.В., Барбараш О.Л., Кашталап В.В., Старин-ская М.А. Анализ показателей смертности от инфаркта миокарда в Российской Федерации в 2006 и 2015 годах. Российский кардиологический журнал. 2017;(11):22-6. DOI: 10.15829/1560-4071-2017-11-22-26.
6. Khera S., Kolte D., Gupta T., Subramanian K., Khanna N., Aronow W., et al. Temporal Trends and Sex Differences in Revascularization and Outcomes of ST-Segment Elevation Myocardial Infarction in Younger Adults in the United States. J Am Coll Cardiol. 2015;66(18):1961-72. DOI: 10.1016/j.jacc.2015.
7. Алекян Б.Г., Ганюков В.И., Маношкина Е.М., Протопопов А.В., Скрыпник Д.В., Кислухин Т.В. Реваскуляризация при инфаркте миокарда с подъемом сегмента ST в Российской Федерации. Анализ результатов 2018 года. Эндоваскулярная хирургия. 2019;6(2):89-97. DOI: 10.24183/24094080-2019-6-2-89-97.
8. Doll J.A., Roe M.T. Time to treatment as a quality metric for acute STEMI care. Lancet. 2015;385(9973):1056-7. DOI: 10.1016/S0140-6736(14)62051-1.
9. Bainey K.R., Mehta S.R, Lai T., Welsh R.C. Complete vs culprit-only revascularization for patients with multination disease undergoing primary percutaneous coronary intervention for ST - segment elevation myocardial infarction: a systematic review and meta-analysis. Am. Heart J. 2014;167(1):1-14. DOI: 10.1016/j.ahj.2013.09.018.
10. Gershlick AH, Khan JN, Kelly DJ, Greenwood JP, Sasikaran T, Curzen N, et al. Randomized trial of complete versus lesion-only revascularization in patients undergoing primary percutaneous coronary intervention for STEMI and multivessel disease: the CvLPRIT trial. J Am Coll Cardiol. 2015;65(10):963-72. DOI: 10.1016/j.jacc.2014.12.038.
11. D'Souza SP, Baxter GF. B Type natriuretic peptide: a good omen in myocardial ischaemia? Heart. 2003;89(7):707-9. DOI: 10.1136/heart.89.7.707.
12. Omland T, Persson A, Ng L, O'Brien R, Karlsson T, Herlitz J, et al. N-terminal pro-B-type natriuretic peptide and longterm mortality in acute coronary syndromes. Circulation. 2002;106(23):2913-8. DOI: 10.1161/01.cir.0000041661.63285.ae.
13. Хроническая сердечная недостаточность. Клинические рекомендации РКО 2020.
14. Острый инфаркт миокарда с подъемом сегмента ST электрокардиограммы. Национальные рекомендации РКО 2020.
15. Хоролец Е.В. Шлык С.В. Прогноз пациентов острым инфарктом миокарда на госпитальном этапе лечения. Современные проблемы науки и образования. 2019;1:74. eLIBRARY ID: 37031934.
16. van Kimmenade RR, Pinto YM, Bayes-Genis A, Lainchbury JG, Richards AM, Januzzi JL Jr. Usefulness of intermediate aminoterminal pro-brain natriuretic peptide concentrations for diagnosis and prognosis of acute heart failure. Am J Cardiol. 2006;98(3):386-90. DOI: 10.1016/j.amjcard.2006.02.043.
17. Протасов В.Н., Скворцов А.А., Кошкина Д.Е., Нарусов О.Ю., Терещенко С.Н. Использование современных биомаркеров в стратификации риска пациентов с сердечной недостаточностью. Кардиологический вестник. 2014;4:100-105. eLIBRARY ID: 22669306.
18. McDonagh T.A., Metra M., Adamo M., Gardner R.S., Baumbach A., Bohm M. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology With the special contribution of the Heart Failure Association of the ESC. European Heart Journal. 2021;42(36):3599-3726. DOI: 10.1093/eurheartj/ehab368.
19. Jernberg T, Stridsberg M, Venge P, Lindahl B. N-terminal pro brain natriuretic peptide on admission for early risk stratification of patients with chest pain and no ST-segment elevation. J Am Coll Cardiol. 2002;40(3):437-45. DOI: 10.1016/s0735-1097(02)01986-1.
20. Кесов П.Г., Рейтблат О.М., Сафиуллина З.М., Шалаев С.В. Эволюция тромболитической терапии в лечении инфаркта миокарда. Рациональная фармакотерапия в кардиологии. 2014;10(5): 554-558. eLIBRARY ID: 22455897.
Review
For citations:
Khorolets E.V., Akhverdieva M.K. Clinical and biochemical parameters in patients with acute heart failure secondary to myocardial infarction. South Russian Journal of Therapeutic Practice. 2022;3(1):60-66. (In Russ.) https://doi.org/10.21886/2712-8156-2022-3-1-60-66
Views:
1065
Email this article 