SHORT-TERM AND LONG-TERM PROGNOSIS OF PATIENTS WITH A FIRST ACUTE MYOCARDIAL-INFARCTION WITH CONCOMITANT PERIPHERAL VASCULAR-DISEASE

被引:22
作者
BEHAR, S
ZION, M
REICHERREISS, H
KAPLINSKY, E
GOLDBOURT, U
机构
[1] Neufeld Cardiac Research Institute, Sheba Medical Center, Tel Hashomer
关键词
D O I
10.1016/0002-9343(94)90110-4
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
PURPOSE: The aim of the study was to assess the prevalence and the prognostic impact of concomitant peripheral vascular disease (PVD) in patients developing acute myocardial infarction (AMI). PATIENTS AND METHODS: Four thousand two hundred fifty-eight consecutive patients with a first AMI hospitalized in 13 of 21 operating coronary care units in Israel were screened. Anamnestic, demographic, and medical data were collected from hospitalization charts, and all patients were followed clinically 1 year after discharge and up to 7 years (mean: 5.5 years) for mortality. RESULTS: The prevalence of clinically diagnosed PVD in patients with a first AMI was 6.3% (269 of 4,258), with no difference between men and women. Patients with PVD were older (66.2 years) and included more hypertensive subjects (47.2%), diabetic persons (26.4%), and individuals with a previous history of cerebrovascular accident (CVA) (11.5%) in comparison to counterparts without PVD (61.7 years; 39.4%, 19.9%, and 3.3%, respectively; p <0.01 for each). On admission to the coronary care units, 36.5% of patients with PVD were in Killip class II, III, or IV versus only 18.0% in the reference group (p <0.001). During hospitalization, patients with PVD exhibited a significantly higher rate of paroxysmal atrial fibrillation (17.5%), advanced atrioventricular block (15.2%), and cardiogenic shock (11.9%) in comparison to patients without PVD (11.9%, 10.2%, and 5.3%, respectively; p <0.01 for each). After adjustment for age, gender, hypertension, history of angina, diabetes mellitus, history of CVA, site of infarction, and congestive heart failure on admission, the odds ratio for in-hospital mortality associated with PVD was 1.37 (90% confidence interval 1.01 to 1.83). There was no independent contribution of PVD to long-term (mean: 5.5 years) postdischarge mortality; the odds ratio was 1.02. CONCLUSION: PVD in patients with a first AMI independently increases the risk of in-hospital death but does not affect long-term mortality in survivors.
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页码:15 / 19
页数:5
相关论文
共 16 条
  • [1] COOPERMAN M, 1978, SURGERY, V84, P505
  • [2] COX DR, 1972, J R STAT SOC B, V34, P187
  • [3] MORTALITY OVER A PERIOD OF 10 YEARS IN PATIENTS WITH PERIPHERAL ARTERIAL-DISEASE
    CRIQUI, MH
    LANGER, RD
    FRONEK, A
    FEIGELSON, HS
    KLAUBER, MR
    MCCANN, TJ
    BROWNER, D
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1992, 326 (06) : 381 - 386
  • [4] CUTLER BS, 1986, SURG CLIN N AM, V66, P281
  • [5] EVALUATION AND MANAGEMENT OF PATIENTS WITH BOTH PERIPHERAL VASCULAR AND CORONARY-ARTERY DISEASE
    GERSH, BJ
    RIHAL, CS
    ROOKE, TW
    BALLARD, DJ
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1991, 18 (01) : 203 - 214
  • [6] Hertzer N R, 1987, Ann Vasc Surg, V1, P616, DOI 10.1016/S0890-5096(06)61452-0
  • [7] CORONARY-ARTERY DISEASE IN PERIPHERAL VASCULAR PATIENTS - A CLASSIFICATION OF 1000 CORONARY ANGIOGRAMS AND RESULTS OF SURGICAL-MANAGEMENT
    HERTZER, NR
    BEVEN, EG
    YOUNG, JR
    OHARA, PJ
    RUSCHHAUPT, WF
    GRAOR, RA
    DEWOLFE, VG
    MALJOVEC, LC
    [J]. ANNALS OF SURGERY, 1984, 199 (02) : 223 - 233
  • [8] LATE RESULTS OF CORONARY-BYPASS IN PATIENTS WITH PERIPHERAL VASCULAR-DISEASE .2. 5-YEAR SURVIVAL ACCORDING TO SEX, HYPERTENSION, AND DIABETES
    HERTZER, NR
    YOUNG, JR
    BEVEN, EG
    OHARA, PJ
    GRAOR, RA
    RUSCHHAUPT, WF
    MALJOVEC, LC
    [J]. CLEVELAND CLINIC JOURNAL OF MEDICINE, 1987, 54 (01) : 15 - 23
  • [9] JAMIESON WRE, 1982, CIRCULATION, V66, P92
  • [10] INTERMITTENT CLAUDICATION - INCIDENCE IN FRAMINGHAM STUDY
    KANNEL, WB
    SKINNER, JJ
    SCHWARTZ, MJ
    SHURTLEFF, D
    [J]. CIRCULATION, 1970, 41 (05) : 875 - +