[Characteristics of acute myocardial infarction patients treated with mechanical ventilation. Data from the ARIAM Registry].
BACKGROUND
Scarce information is available about the use, clinical course and follow-up of patients with acute myocardial infarction treated with mechanical ventilation.


METHODS
Historical cohort study of patients with acute myocardial infarction, included in Spanish registry ARIAM. Differences in clinical characteristics and prognosis from patients treated with or without mechanical ventilation were compared.


RESULTS
Three hundred and thirty-three of the 4143 patients (8.1%) with acute myocardial infarction were treated with mechanical ventilation. Treated patients were older, more frequently female, and had more frequently reinfarcts, anterior infarction, Killip III and IV, and higher creatine phosphokinase peak. Diabetes and high blood pressure were more frequent in those in which the technique was applied. They had a higher mortality at the coronary care unit (65.7 vs 5.1%; p < 0.001) than the non-ventilated patients. In multivariate analysis, creatine phosphokinase peak levels higher than 1.200 units/ml, Killip III and IV, and an infarction localization different to inferior were independent predictors of mechanical ventilation application. The 220 treated patients who died were older, more frequently female, had been more frequently admitted to the coronary unit, and had Killip IV whereas Killip III was more frequent among survivors. In multivariate analysis, restricted to patients treated with mechanical ventilation, Killip III was an independent predictor of survival with an odds ratio for mortality of 0.26 (CI 95%: 0.09-0.77).


CONCLUSIONS
Mechanical ventilation is a vital support technique employed in a significant number of complicated acute myocardial infarction patients. The high mortality of these patients was related to more extended myocardial infarction and a worse clinical state.
López Messa
J B
JB
Unidad Coronaria. Servicio de Medicina Intensiva. Hospital General Río Carrión. Palencia. jlomessa@ariam.net
Andrés De Llano
J M
JM
Berrocal De La Fuente
C A
CA
Pascual Palacín
R
R
D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000503:physiopathology*; D012042:Registries; D012121:Respiration, Artificial