Predictors and mid-term outcomes of nosocomial infection  in ST-elevation myocardial infarction patients treated  by primary angioplasty

Santos, Mariana; Oliveira, Marta Fontes; Vieira, Susete; Magalhães, Rui; Costa, Ricardo; Brochado, Bruno; Santos, Raquel B.; Silveira, João; Torres, Severo; Luz, André

doi:10.33963/kp.a2021.0058

Cited by 5 publications

(5 citation statements)

References 26 publications

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“…Szczepaniak et al [ 28 ] presented the inflammatory link between hypertension and periodontitis. Inflammatory reaction related to nosocomial infection was described as a possible risk factor for worse presentation and outcomes after acute coronary syndrome [ 29 ]. Moreover, Fan et al [ 30 ] identified a series of key genes closely related with inflammatory response and atrial fibrillation.…”

Section: Discussionmentioning

confidence: 99%

Pre-operative systemic inflammatory response index influences long-term survival rate in off-pump surgical revascularization

et al. 2022

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Coronary artery bypass revascularization is still the optimal treatment for complex coronary artery disease with good long-term results. The relation between inflammatory activation in the post-operative period and the long-term prognosis was already postulated. The possible predictive role of preoperative inflammatory indexes after the off-pump coronary artery bypass grafting technique on long term survival was the aim of the study. Study population included 171 patients with a median age of 64 years (59–64) operated on using off-pump technique between January and December 2014. Patients enrolled in the current study were followed-up for 8 years. We conducted a multivariable analysis of pre-operative and post-operative inflammatory markers based on analysis of the whole blood count. The overall survival rate was 80% for the total follow-up period, while 34 deaths were reported (30-days mortality rate of 1%). In the multivariable analysis, a pre-operative value of systemic inflammatory response index (SIRI) >1.27 (HR = 6.16, 95% CI 2.17–17.48, p = 0.012) revealed a prognostic value for long-term mortality assessment after off-pump surgery. Preoperative inflammatory activation evaluated by systemic inflammatory reaction index (SIRI) possess a prognostic value for patients with complex coronary artery disease. The SIRI value above 1.27 indicates a worse late prognosis after off-pump coronary artery bypass (AUC = 0.682, p<0.001).

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Section: Discussionmentioning

confidence: 99%

Pre-operative systemic inflammatory response index influences long-term survival rate in off-pump surgical revascularization

et al. 2022

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“…As an important complication of STEMI, infection during hospitalization is associated with a worse clinical outcome [ 1 – 4 ], and several risk factors [ 24 , 25 ] and scores [ 4 , 26 , 27 ] are utilized for infection prediction and prevention. Unfortunately, these predictive tools are largely complex or unable to be interfered.…”

Section: Discussionmentioning

confidence: 99%

Positive association between stress hyperglycemia ratio and pulmonary infection in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention

Zhou

Liang

Zhang

et al. 2023

Cardiovasc Diabetol

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Background Previous studies have shown that the stress hyperglycemia ratio (SHR), a parameter of relative stress-induced hyperglycemia, is an excellent predictive factor for all-cause mortality and major adverse cardiovascular events (MACEs) among patients with ST-segment elevation myocardial infarction (STEMI). However, its association with pulmonary infection in patients with STEMI during hospitalization remains unclear. Methods Patients with STEMI undergoing percutaneous coronary intervention (PCI) were consecutively enrolled from 2010 to 2020. The primary endpoint was the occurrence of pulmonary infection during hospitalization, and the secondary endpoint was in-hospital MACEs, composed of all-cause mortality, stroke, target vessel revascularization, or recurrent myocardial infarction. Results A total of 2,841 patients were finally included, with 323 (11.4%) developing pulmonary infection and 165 (5.8%) developing in-hospital MACEs. The patients were divided into three groups according to SHR tertiles. A higher SHR was associated with a higher rate of pulmonary infection during hospitalization (8.1%, 9.9%, and 18.0%, P < 0.001) and in-hospital MACEs (3.7%, 5.1%, and 8.6%, P < 0.001). Multivariate logistic regression analysis demonstrated that SHR was significantly associated with the risk of pulmonary infection during hospitalization (odds ratio [OR] = 1.46, 95% confidence interval [CI] 1.06–2.02, P = 0.021) and in-hospital MACEs (OR = 1.67, 95% CI 1.17–2.39, P = 0.005) after adjusting for potential confounding factors. The cubic spline models demonstrated no significant non-linear relationship between SHR and pulmonary infection (P = 0.210) and MACEs (P = 0.743). In receiver operating characteristic curve, the best cutoff value of SHR for pulmonary infection was 1.073. Conclusions The SHR is independently associated with the risk of pulmonary infection during hospitalization and in-hospital MACEs for patients with STEMI undergoing PCI.

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“…Therefore, a simple and readily available pathophysiological biomarker of pulmonary infection is required to detect high risk patients as early as possible and ultimately improve their short-and long-term prognoses. Although several risk factors and scores are available to predict infection in patients with STEMI undergoing PCI, they are often complicated and are not easily applied 4,[7][8][9][10] .…”

Section: Endpoints and Definitionsmentioning

confidence: 99%

Serum Albumin-to-Creatinine Ratio: A Novel Predictor of Pulmonary Infection in Patients with ST-Segment Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention

Kong,

Yu,

et al. 2024

JAT

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Aim: In patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI), a low serum albumin-to-creatinine ratio (sACR) is associated with elevated risk of poor shortand long-term outcomes. However, the relationship between sACR and pulmonary infection during hospitalization in patients with STEMI undergoing PCI remains unclear. Methods: A total of 4,507 patients with STEMI undergoing PCI were enrolled and divided into three groups according to sACR tertile. The primary outcome was pulmonary infection during hospitalization, and the secondary outcome was in-hospital major adverse cardiovascular events (MACE ) including stroke, in-hospital mortality, target vessel revascularization, recurrent myocardial infarction, and all-cause mortality during follow-up. Results: Overall, 522 (11.6%) patients developed pulmonary infections, and 223 (4.9%) patients developed in-hospital MACE. Cubic spline models indicated a non-linear, L-shaped relationship between sACR and pulmonary infection (P=0.039). Receiver operating characteristic curve analysis indicated that sACR had good predictive value for both pulmonary infection (area under the ROC curve [AUC]=0.73, 95% CI=0.70-0.75, P＜ 0.001) and in-hospital MACE (AUC=0.72, 95% CI=0.69-0.76, P＜0.001). Kaplan-Meier survival analysis indicated that higher sACR tertiles were associated with a greater cumulative survival rate (P＜0.001). Cox regression analysis identified lower sACR as an independent predictor of long-term all-cause mortality (hazard ratio [HR]=0.96, 95% CI=0.95-0.98, P＜0.001). Conclusions: A low sACR was significantly associated with elevated risk of pulmonary infection and MACE during hospitalization, as well as all-cause mortality during follow-up among patients with STEMI undergoing PCI. These findings highlighted sACR as an important prognostic marker in this patient population.

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Predictors and mid-term outcomes of nosocomial infection in ST-elevation myocardial infarction patients treated by primary angioplasty

Abstract: w w w . j o u r n a l s . v i a m e d i c a . p l / k a r d i o l o g i a _ p o l s k a

Cited by 5 publications

References 26 publications

Pre-operative systemic inflammatory response index influences long-term survival rate in off-pump surgical revascularization

Pre-operative systemic inflammatory response index influences long-term survival rate in off-pump surgical revascularization

Positive association between stress hyperglycemia ratio and pulmonary infection in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention

Serum Albumin-to-Creatinine Ratio: A Novel Predictor of Pulmonary Infection in Patients with ST-Segment Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention

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