MARIA HRISTOVA MILANOVA1, STEFAN NAYDENOV NAYDENOV2, NIKOLAY MARGARITOV RUNEV2, EMIL IVANOV MANOV2
1UMBALSM “N.I.Pirogov”, Clinic of cardiology, Sofia, Bulgaria - 2Department of Internal Diseases “Prof. St. Kirkovich”, Medical University of Sofia, Bulgaria
Introduction: Arterial hypertension (HTN), dyslipidemias, diabetes mellitus (DM) and smoking are accepted to be major modifiable risk factors (RF) for cardiovascular morbidity and mortality worldwide. Nevertheless their role for the prognosis of patients early after an acute cardiovascular event has not been fully elucidated.
The aim of our study was to evaluate the impact of HTN, dyslipidemia, DM and smoking on the early prognosis of patients with acute myocardial infarction (AMI).
Materials and methods: We included 682 consecutive patients with AMI, mean age 66.6 ± 12.9 years. Detailed information was collected about the cardiovascular RF of the patients, concomitant diseases, demographic and socio-economic data.
Results: Acute myocardial infarction with persistent ST-elevation was diagnosed in 344 (50.4%) patients. Arterial hyperten- sion was present in 589 (86.4%), dyslipidemia - 347 (50.9%), active smoking - 178 (26.1%), type 2 DM - 171 (25.1%). In-hospital mortality was 13.6% (n=89): 14.1% (n=46) for ST-elevation AMI and 12.7% (n=38) for non-ST-elevation AMI, p=N.S. The impact of the analyzed RF on the early prognosis, demonstrated by the odds ratio (OR) for lethal outcome was as follows: HTN - OR = 3.19, p<0.0001, DM - OR = 2.20, p = 0.003, dyslipidemia – OR = 1.80, p=0.03, active smoking - OR = 0.35, p = 0.005.
Conclusion: Prevalence of HTN, dyslipidemia, type 2 DM and active smoking in patients with AMI in our study was high with HTN being the most influential RF in regard to the early post-infarction prognosis. While the first three RF were associated with increased early mortality, surprisingly active smoking reduced the risk for unfavourable outcome.
hypertension, dyslipidemia, diabetes, smoking, infarction, mortality