A proposed functional clinical classification predicts in-hospital and long-term survival in the setting of acute right ventricular infarction / Propuesta de una clasificación funcional y clínica para predecir la sobrevida intrahospitalaria y a largo plazo de enfermos con infarto agudo del ventrículo derecho
Arch. cardiol. Méx
;
78(4): 369-378, Oct.-Dec. 2008.
Artigo
em Inglês
| LILACS
| ID: lil-565637
ABSTRACT
BACKGROUND:
The objectives of the present investigation were to validate the prognostic role of a proposed Clinical Classification [CC], to evaluate the TIMI risk score [RS] and to establish whether the TIMI-RS should incorporate points for patients with acute right ventricular infarction [TIMI-RS-RVI]. METHODS ANDRESULTS:
A total of 523 RVI patients were classified on clinical and functional basis as A, without right ventricular failure [RVF], B with RVF and C with cardiogenic shock. The CC was evaluated prospectively among 98 patients with RVI and retrospectively in 425 RVI patients. The TIMI-RS was evaluated prospectively among 622 patients with STEMI [anterior277, inferior247, RVI98], and retrospectively in 425 RVI patients. The CC established differences among the 3-RVI Classes for in-hospital mortality [prospectively and retrospectively; p<0.01, p<0.001, respectively] that were maintained at 8 years [p < 0.001]. Patients with anterior and inferior STEMI, but not those with RVI revealed an association between outcome and TIMI-RS [p<0.001]. Testing for TIMI-RS-RVI did not result a good prognostic tool [ROC=0.9; excellent discrimination, but with a very poor [quot ]clinical calibration[quot ]].CONCLUSIONS:
The proposed CC allowed prediction of mortality at short- and long-term in the setting of acute RVI. The role of the TIMI-RS should be reevaluated prospectively as a prognostic tool in the scenario of RVI patients.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Mortalidade Hospitalar
/
Disfunção Ventricular Direita
/
Infarto do Miocárdio
Tipo de estudo:
Estudo de etiologia
/
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Limite:
Idoso
/
Humanos
Idioma:
Inglês
Revista:
Arch. cardiol. Méx
Assunto da revista:
Cardiologia
Ano de publicação:
2008
Tipo de documento:
Artigo
País de afiliação:
México
Instituição/País de afiliação:
Instituto Nacional de Cardiologia Ignacio Chavez/MX
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