Outcomes of Acute Myocardial Infarction in Patients with Hypertrophic Cardiomyopathy

被引：34

作者：

Gupta, Tanush ^{[1
]}

Harikrishnan, Prakash ^{[1
]}

Kolte, Dhaval ^{[1
]}

Khera, Sahil ^{[2
]}

Aronow, Wilbert S. ^{[2
]}

Mujib, Marjan ^{[1
]}

Palaniswamy, Chandrasekar ^{[3
]}

Sule, Sachin ^{[1
]}

Jain, Diwakar ^{[2
]}

Ahmed, Ali ^{[4
]}

Lanier, Gregg M. ^{[2
]}

Cooper, Howard A. ^{[2
]}

Frishman, William H. ^{[2
]}

Fonarow, Gregg C. ^{[5
]}

Panza, Julio A. ^{[2
]}

机构：

[1] New York Med Coll, Dept Med, Valhalla, NY 10595 USA

[2] New York Med Coll, Div Cardiol, Valhalla, NY 10595 USA

[3] Mt Sinai Med Ctr, New York, NY 10029 USA

[4] Vet Affairs Med Ctr, Washington, DC 20422 USA

[5] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA

来源：

AMERICAN JOURNAL OF MEDICINE | 2015年 / 128卷 / 08期

关键词：

Acute myocardial infarction; Hypertrophic cardiomyopathy; In-hospital mortality; Revascularization; CORONARY-ARTERY-DISEASE; LEFT-VENTRICULAR OUTFLOW; VASODILATOR RESERVE; DOPPLER-ECHOCARDIOGRAPHY; CLINICAL-IMPLICATIONS; SUBAORTIC STENOSIS; FILLING PRESSURES; FLOW RESERVE; MANAGEMENT; ISCHEMIA;

D O I：

10.1016/j.amjmed.2015.02.025

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND: Acute myocardial infarction is a recognized complication in patients with hypertrophic cardiomyopathy. However, limited data are available on outcomes of patients with hypertrophic cardiomyopathy and acute myocardial infarction. METHODS: We analyzed the 2003-2011 Nationwide Inpatient Sample databases to identify all patients aged >= 18 years with a principal diagnosis of acute myocardial infarction. Patients with a concomitant diagnosis of hypertrophic cardiomyopathy were then identified and analyzed as a separate cohort. Multivariate logistic regression was used to compare outcomes in patients with acute myocardial infarction with and without hypertrophic cardiomyopathy. RESULTS: Of 5,901,827 patients with acute myocardial infarction, 5688 (0.1%) had a diagnosis of hypertrophic cardiomyopathy. Patients with hypertrophic cardiomyopathy were older, more likely to be female, and less likely to have traditional cardiovascular risk factors. Compared with patients without hypertrophic cardiomyopathy, patients with hypertrophic cardiomyopathy were less likely to present with ST-elevation myocardial infarction and more likely to present with non-ST-elevation myocardial infarction. Patients with hypertrophic cardiomyopathy with ST-elevation myocardial infarction or non-ST-elevation myocardial infarction were less likely to receive revascularization. In the overall population with acute myocardial infarction, there was no difference in risk-adjusted in-hospital mortality between patients with and without hypertrophic cardiomyopathy (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.84-1.11; P = .59). In the population with ST-elevation myocardial infarction, patients with hypertrophic cardiomyopathy had lower risk-adjusted in-hospital mortality than those without hypertrophic cardiomyopathy (OR, 0.75; 95% CI, 0.63-0.91; P = .003), whereas in the population with noneST-elevation myocardial infarction, there was no difference in risk-adjusted in-hospital mortality between patients with and without hypertrophic cardiomyopathy (OR, 0.97; 95% CI, 0.84-1.11; P = .63). CONCLUSIONS: Patients with hypertrophic cardiomyopathy represent a small proportion of patients with acute myocardial infarction and are less likely to receive revascularization. Compared with patients without hypertrophic cardiomyopathy, patients with hypertrophic cardiomyopathy with ST-elevation myocardial infarction have lower risk-adjusted in-hospital mortality. (C) 2015 Elsevier Inc. All rights reserved.

引用

页码：879 / +

页数：10

共 35 条

[1] MYOCARDIAL ISCHEMIA IN PATIENTS WITH HYPERTROPHIC CARDIOMYOPATHY - CONTRIBUTION OF INADEQUATE VASODILATOR RESERVE AND ELEVATED LEFT-VENTRICULAR FILLING PRESSURES [J].