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Very low risk ST-segment elevation myocardial infarction? It exists and may be easily identified

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dc.contributor.author Díez Delhoyo, Felipe
dc.contributor.author Valero Masa, María Jesús
dc.contributor.author Velásquez Rodríguez, Jesús
dc.contributor.author Devesa Cordero, Carolina
dc.contributor.author Sousa Casasnovas, Iago
dc.contributor.author Juárez, Míriam
dc.contributor.author Angulo Llanos, Rocío
dc.contributor.author Fernández Fernández-Avilés, Francisco
dc.contributor.author Martínez Sellés Oliveria Soares, Manuel
dc.date.accessioned 2017-01-05T08:46:49Z
dc.date.available 2017-01-05T08:46:49Z
dc.date.issued 2017
dc.identifier.citation Díez-Delhoyo, F., Valero-Masa, M. J., Velásquez-Rodríguez, J., Devesa-Cordero, C., Sousa-Casasnovas, I., Juárez, M., ... & Martínez-Sellés, M. (2017). Very low risk ST-segment elevation myocardial infarction? It exists and may be easily identified. International Journal of Cardiology, 228, 615-620. DOI: 10.1016/j.ijcard.2016.11.276 spa
dc.identifier.issn 01675273
dc.identifier.uri http://hdl.handle.net/11268/6136
dc.description.abstract Early discharge protocols have been proposed for ST-segment elevation myocardial infarction (STEMI) low risk patients despite the existence of few but significant cardiovascular events during mid-term follow-up. We aimed to identify a subgroup of patients among those considered low-risk in which prognosis would be particularly good. We analyzed 30-day outcomes and long-term follow-up among 1.111 STEMI patients treated with reperfusion therapy. Multivariate analysis identified seven variables as predictors of 30-day outcomes: Femoral approach; age > 65; systolic dysfunction; postprocedural TIMI flow < 3; elevated creatinine level > 1.5 mg/dL; stenosis of left-main coronary artery; and two or higher Killip class (FASTEST). A total of 228 patients (20.5%), defined as very low-risk (VLR), had none of these variables on admission. VLR group of patients compared to non-VLR patients had lower in-hospital (0% vs. 5.9%; p < 0.001) and 30-day mortality (0% vs. 6.25%: p < 0.001). They also presented fewer in-hospital complications (6.6% vs. 39.7%; p < 0.001) and 30-day major adverse events (0.9% vs. 4.5%; p = 0.01). Significant mortality differences during a mean follow-up of 23.8 ± 19.4 months were also observed (2.2% vs. 15.2%; p < 0.001). The first VLR subject died 11 months after hospital discharge. No cardiovascular deaths were identified in this subgroup of patients during follow-up. About a fifth of STEMI patients have VLR and can be easily identified. They have an excellent prognosis suggesting that 24–48 h in-hospital stay could be a feasible alternative in these patients. spa
dc.description.sponsorship SIN FINANCIACIÓN spa
dc.language.iso eng spa
dc.title Very low risk ST-segment elevation myocardial infarction? It exists and may be easily identified spa
dc.type article spa
dc.description.impact 4.034 JCR (2017) Q2, 41/128 Cardiac and Cardiovascular Systems spa
dc.identifier.doi 10.1016/j.ijcard.2016.11.276
dc.rights.accessRights closedAccess spa
dc.subject.uem Infarto de miocardio spa
dc.subject.uem Cardiopatía coronaria spa
dc.subject.unesco Enfermedad cardiovascular spa
dc.subject.unesco Sistema cardiovascular spa
dc.description.filiation UEM spa
dc.peerreviewed Si spa


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