Characteristics and Prognosis of Type 2 Myocardial Infarction Through Worsening Renal Function and NT-proBNP in Older Adults with Pneumonia

IF 3.6 3区 医学
Jinling Ma, Suyan Bian, Ang Li, Qian Chen
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Abstract

Background: Type 2 myocardial infarction (MI) is becoming more recognized. This study aimed to assess the factors linked to type 2 MI in older adults with pneumonia and further determine the predictive factors of 90-day adverse events (refractory heart failure, cardiogenic shock, and all-cause mortality).
Methods: A single-center retrospective analysis was conducted among older adults with pneumonia. The primary outcome was the prevalence of type 2 MI. The secondary objective was to assess the adverse events in these patients with type 2 MI within 90 days.
Results: A total of 2618 patients were included. Of these, 361 patients (13.8%) suffered from type 2 MI. Multivariable predictors of type 2 MI were chronic kidney disease (CKD), age-adjusted Charlson comorbidity index (ACCI) score, and NT-proBNP > 4165pg/mL. Moreover, the independent predictive factors of 90-day adverse events included NT-proBNP > 4165pg/mL, age, ACCI score, and CKD. The Kaplan–Meier adverse events curves revealed that the type 2 MI patients with CKD and NT-proBNP > 4165pg/mL had a higher risk than CKD or NT-proBNP > 4165pg/mL alone.
Conclusion: Type 2 MI in older pneumonia hospitalization represents a heterogeneous population. Elevated NT-proBNP level and prevalence of CKD are important predictors of type 2 MI and 90-day adverse events in type 2 MI patients.

通过肺炎老年人肾功能恶化和 NT-proBNP 预测 2 型心肌梗死的特征和预后
背景:2型心肌梗死(MI)越来越受到重视。本研究旨在评估老年肺炎患者中与 2 型心肌梗死相关的因素,并进一步确定 90 天不良事件(难治性心力衰竭、心源性休克和全因死亡率)的预测因素:对患有肺炎的老年人进行了单中心回顾性分析。主要结果是2型心肌梗死的发生率。次要目标是评估这些 2 型心肌梗死患者在 90 天内发生的不良事件:结果:共纳入 2618 名患者。结果:共纳入 2618 名患者,其中 361 名患者(13.8%)患有 2 型心肌梗死。2 型心肌梗死的多变量预测因素为慢性肾脏病(CKD)、年龄调整后的夏尔森合并症指数(ACCI)评分和 NT-proBNP > 4165pg/mL。此外,90 天不良事件的独立预测因素包括 NT-proBNP > 4165pg/mL、年龄、ACCI 评分和 CKD。Kaplan-Meier不良事件曲线显示,伴有CKD和NT-proBNP > 4165pg/mL的2型心肌梗死患者的风险高于仅伴有CKD或NT-proBNP > 4165pg/mL的患者:结论:老年肺炎住院患者中的2型心肌梗死是一个异质性人群。NT-proBNP水平升高和CKD患病率是2型心肌梗死和2型心肌梗死患者90天不良事件的重要预测因素。
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来源期刊
Clinical Interventions in Aging
Clinical Interventions in Aging GERIATRICS & GERONTOLOGY-
CiteScore
6.20
自引率
2.80%
发文量
193
期刊介绍: Clinical Interventions in Aging, is an online, peer reviewed, open access journal focusing on concise rapid reporting of original research and reviews in aging. Special attention will be given to papers reporting on actual or potential clinical applications leading to improved prevention or treatment of disease or a greater understanding of pathological processes that result from maladaptive changes in the body associated with aging. This journal is directed at a wide array of scientists, engineers, pharmacists, pharmacologists and clinical specialists wishing to maintain an up to date knowledge of this exciting and emerging field.
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