Laboratory and instrumental parameters associated with the long-term mortality risk in patients after myocardial infarction
- Authors: Mushikhina N.A.1, Gorbatenko E.A.1, Teploukhova A.I.1, Yaroslavskaya E.I.1, Larionova O.N.1
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Affiliations:
- Tomsk National Research Medical Center of the Russian Academy of Sciences
- Issue: Vol 105, No 6 (2024)
- Pages: 869-878
- Section: Theoretical and clinical medicine
- Submitted: 16.05.2024
- Accepted: 02.09.2024
- Published: 27.11.2024
- URL: https://kazanmedjournal.ru/kazanmedj/article/view/632059
- DOI: https://doi.org/10.17816/KMJ632059
- ID: 632059
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Abstract
BACKGROUND: The risk of death remains high in patients who survive 1 year after myocardial infarction (MI).
AIM: To identify the laboratory and instrumental parameters of myocardial remodeling associated with long-term mortality in patients 1 year after MI.
MATERIAL AND METHODS: The study included 184 patients who survived 1 year after MI. Group 1 included living patients who were followed up for 5 years after MI (n = 160). group 2 comprised patients who had died by the 5-year mark (n = 24). Inflammation and myocardial dysfunction biomarkers and echocardiographic parameters reflecting types of left ventricular remodeling, linear dimensions of cardiac cavities, wall thickness, chamber volumes, and systolic ventricular function were retrospectively analyzed. After analyzing the distribution of numerical data, the Student’s t-test or Mann–Whitney U test and χ2 test for categorical variables were applied. A logistic regression model was developed. This model was validated and assessed for reliability using the receiver operator characteristics curve, Hosmer–Lemeshow goodness-of-fit test, and bootstrap method.
RESULTS: Patients in group 2 were older (p = 0.007) and more likely to experience ST-segment elevation MI during hospitalization (p < 0.001). One year after the MI, a complex pattern of N-terminal brain natriuretic propeptide level changes was observed, with a decrease in group 1 and an increase in group 2. The end-diastolic volume index (p = 0.014) and left ventricular asynergy size were higher (p = 0.043) and the ejection fraction was lower (p = 0.015) in group 2 than in group 1. The model for predicting 4-year mortality in patients who survived MI during the first year includes parameters such as the left ventricular end-diastolic volume index, N-terminal pro-brain natriuretic peptide level, and presence of concentric left ventricular hypertrophy.
CONCLUSION: In patients who survive 1 year following MI, long-term mortality risk is associated with parameters reflecting left ventricular remodeling and heart failure development.
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About the authors
Natalia A. Mushikhina
Tomsk National Research Medical Center of the Russian Academy of Sciences
Author for correspondence.
Email: musihina@infarkta.net
ORCID iD: 0000-0002-8280-2028
SPIN-code: 9244-6574
Scopus Author ID: 6504001940
MD, Cand. Sci. (Med.), Head of Depart., Depart. of Emergency Cardiology, Scientific Depart. of Clinical Cardiology, Tyumen Cardiology Research Center, Tomsk National Research Medical Center
Russian Federation, TomskElena A. Gorbatenko
Tomsk National Research Medical Center of the Russian Academy of Sciences
Email: elena@infarkta.net
ORCID iD: 0000-0003-3675-1503
SPIN-code: 9472-4512
Scopus Author ID: 14045151200
ResearcherId: M-8298-2019
Jr. Researcher, Lab. Instrumental Diagnostics, Tyumen Cardiology Research Center
Russian Federation, TomskAlina I. Teploukhova
Tomsk National Research Medical Center of the Russian Academy of Sciences
Email: TeplouhovaAI@infarkta.net
ORCID iD: 0000-0002-7268-3467
SPIN-code: 8230-8965
Scopus Author ID: 57220067896
ResearcherId: AAU-7756-2021
MD, Head of Depart., Depart. of Cardiology No. 1, Jr. Researcher, Depart. of Emergency Cardiology, Scientific Depart. of Clinical Cardiology, Tyumen Cardiology Research Center
Russian Federation, TomskElena I. Yaroslavskaya
Tomsk National Research Medical Center of the Russian Academy of Sciences
Email: Yaroslavskaya@infarkta.net
ORCID iD: 0000-0003-1436-8853
SPIN-code: 6413-5590
Scopus Author ID: 36459379400
MD, Dr. Sci. (Med.), Head of the Lab., Lab. Instrumental Diagnostics, Leading Researcher, Ultrasound Diagnostics Doctor, Tyumen Cardiology Research Center
Russian Federation, TomskOlga N. Larionova
Tomsk National Research Medical Center of the Russian Academy of Sciences
Email: LarionovaON@infarkta.net
ORCID iD: 0000-0001-7721-6633
SPIN-code: 9582-0615
Scopus Author ID: 58730676400
Jr. Researcher, Depart. of Emergency Cardiology, Scientific Depart. of Clinical Cardiology, Tyumen Cardiology Research Center
Russian Federation, TomskReferences
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