Abstract

GARCIA GONZALEZ, MJ et al. Systemic inflammatory response syndrome: incidence and influence on outcome in acute myocardial infarction treated with primary angioplasty. Med. Intensiva [online]. 2007, vol.31, n.6, pp.289-293. ISSN 0210-5691.

Objective. To assess the incidence, clinical profile and influence on outcome of systemic inflammatory response syndrome (SIRS) in patients with acute myocardial infarction (AMI) treated with primary angioplasty (PA). Design. Prospective observational study. Scope. A 12-beds coronary care unit at a university hospital. Patients and methods. Patients with AMI treated with PA, admitted in 2004 were studied. Principal variables of interest. Age, gender, anterior localization of AMI, smoking, arterial hypertension, diabetes mellitus, troponin Ic levels, time delays until PA, heart failure, left ventricular ejection fraction (LVEF), in-hospital length of stay and mortality. Results. Ninety patients were included. SIRS was diagnosed in 15 patients (16.6%), who were older (72 ± 7 vs 66 ± 9 years; p = 0,01). These patients had a greater frequency of diabetes mellitus (42% vs 17%; p = 0.01), higher troponin Ic levels (80 ± 12 vs 68 ± 19 ng/ml; p = 0.02), lower LVEF (41 ± 8% vs 51 ± 12%; p = 0.002), longer in-hospital length of stay (18 ± 5 vs 7 ± 3 days, p = 0.001), and higher in-hospital mortality (10 vs 3%, p = 0.03) compared with patients without SIRS. Diabetes mellitus (OR: 1.7; 95% CI: 1.2-1.9) and lower ejection fraction (OR: 2.3; 95% CI: 1.5-3.1) were the independent predictors of the presence of systemic inflammatory response syndrome. In multivariant analysis SIRS was an independent predictor of mortality in AMI patients treated with PA (OR: 3.3; 95% CI: 1.3-6). Conclusions. Systemic inflammatory response syndrome may be present in AMI patients treated with PA and its presence is associated to a worse outcome and longer in-hospital stay.

Keywords : systemic inflammatory response syndrome; acute myocardial infarction; primary angioplasty; incidence; in-hospital outcome.