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The unexpected silent manifestation of myocardial infarctions in ischemic heart failure patients: Insights from a case-control study
Mendes, Gabriel Cordeiro Polo; Rezende, Paulo Cury; Assis, Arthur Cicupira Rodrigues de; Andrade, Vitor Coutinho; Scudeler, Thiago Luis; Silva, Marcela Francisca da; Mocha, Mauricio Rigodanzo; Hueb, Whady; Ramires, Jose Antonio Franchini; Kalil Filho, Roberto.
Afiliação
  • Mendes, Gabriel Cordeiro Polo; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. São Paulo. BR
  • Rezende, Paulo Cury; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. São Paulo. BR
  • Assis, Arthur Cicupira Rodrigues de; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. São Paulo. BR
  • Andrade, Vitor Coutinho; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. São Paulo. BR
  • Scudeler, Thiago Luis; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. São Paulo. BR
  • Silva, Marcela Francisca da; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. São Paulo. BR
  • Mocha, Mauricio Rigodanzo; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. São Paulo. BR
  • Hueb, Whady; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. São Paulo. BR
  • Ramires, Jose Antonio Franchini; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. São Paulo. BR
  • Kalil Filho, Roberto; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. São Paulo. BR
Clinics ; Clinics;79: 100480, 2024. tab, graf
Article em En | LILACS-Express | LILACS | ID: biblio-1574773
Biblioteca responsável: BR1.1
ABSTRACT
Abstract

Background:

Recent studies show Silent Myocardial Infarction (SMI) as a quite frequent event. However, regarding severe tertiary care patients that frequently present consequences of Coronary Artery Disease (CAD) and Left Ventricular Dysfunction (LVD), the occurrence of this manifestation is unexpected and its associated factors aren't clear in the literature.

Aim:

To compare clinical, laboratorial, ventricular and angiographic factors between silent and classical presentation of MI in patients with CAD and LVD.

Methods:

Patients with multivessel CAD with over 70 % obstructive lesions and LVD with EF less than 35 % were evaluated for MASS VI trial and later included in the present study. The ventricular function and coronary assessment were measured by echocardiography and SYNTAX score, respectively. The population was stratified in a SMI group and Clinically Manifested Myocardial Infarction (CMMI) group based on MI presentation for a comparison of medical parameters.

Results:

From 132 patients, 47 (35.6 %) were classified as SMI and 85 (64.4 %) as CMMI. No differences were observed between groups regarding age, sex, diabetes mellitus, SYNTAX score, or collateral circulation. Higher proportion of NYHA II classification, inferior wall MI and lower creatinine clearance were found in SMI group. After multivariate analysis, peripheral diabetic neuropathy (OR = 4.6 [1.1-12.7] p = 0.032) and inferior wall MI (OR = 4.1 [1.5-11.4] p = 0.007) were significantly associated with SMI.

Conclusion:

Peripheral diabetic neuropathy and inferior wall MI were associated with SMI presentation. Overall, associated factors tend to be similar comparing SMI and CMMI, but in the specific population of diabetic patients with chronic neuropathy a special care should be taken.
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Texto completo: 1 Coleções: 01-internacional Base de dados: LILACS Idioma: En Revista: Clinics Assunto da revista: MEDICINA Ano de publicação: 2024 Tipo de documento: Article / Project document País de afiliação: Brasil País de publicação: Brasil
Texto completo
Adicionar na Minha BVS
Imprimir
XML
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: LILACS Idioma: En Revista: Clinics Assunto da revista: MEDICINA Ano de publicação: 2024 Tipo de documento: Article / Project document País de afiliação: Brasil País de publicação: Brasil