Association between transient pulmonary congestion during acute myocardial infarction and high incidence of death in six months |
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| Authors: | E M Dwyer H Greenberg R B Case |
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| Affiliation: | 1. Hospital Universitari de Bellvitge, L''Hospitalet de Llobregat, Barcelona, Spain;2. Hospital Álvaro Cunqueiro, Vigo, Spain;3. Department of Cardiology, Department of Medical Sciences, University of Torino, Italy;4. University Hospital of Wales, Cardiff, United Kingdom;5. Hospital Universitario Virgen de la Arrixaca, Murcia, Spain;6. University Heart Center, University Hospital Zurich, Switzerland;7. Medical faculty, University of Novi Sad, Novi Sad, Serbia;8. University Patras Hospital, Athens, Greece;9. Interventional Unit, San Luigi Gonzaga University Hospital, Orbassano and Infermi Hospital, Rivoli, Torino, Italy;10. Catheterization Laboratory, Maggiore della Carità Hospital, Novara, Italy;11. Department of Cardiology, S.G. Bosco Hospital, Torino, Italy;12. Department of Cardiology, Faculty of Medicine, Assiut University, Egypt;13. U.O. Cardiologia, Ospedale Valduce, Como, Italy;14. PolitoBIOMed Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Italy;15. Department of Cardiology, University Hospital from Canarias, Tenerife, Spain |
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| Abstract: | In a prospective multicenter study of 866 patients after acute myocardial infarction (AMI), an increased or excessive mortality rate (13%) was confined to the first 6 months after AMI. In the subsequent 18 months of follow-up, the mortality rate (4%) was similar to that in coronary patients in chronic stable condition. Analysis of patients who died in the first 6 months revealed that 55% had had pulmonary congestion at the time of the index AMI. Neither these patients nor the others who died in the early period were found to have more severe ventricular dysfunction, more malignant arrhythmias or more severe ischemia than patients who died after 6 months. The reason for the high and early mortality in patients with pulmonary congestion is not clear, particularly because 30% had reasonable ventricular function, with an ejection fraction of more than 40%. However, given the poor prognosis of these patients, early and aggressive diagnostic efforts should be undertaken to exclude jeopardized regions remote from the initial AMI. |
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