[Systemic inflammatory response syndrome: incidence and influence on outcome in acute myocardial infarction treated with primary angioplasty].
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).


METHODS
Prospective observational study.


METHODS
A 12-beds coronary care unit at a university hospital.


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.
Unidad de Coronarias, Servicio de Cardiología, Hospital Universitario de Canarias, Carretera La Cuesta-Taco, Ofra s/n, 38320 Santa Cruz de Tenerife, Islas Canarias, Spain. mjgg181262@hotmail.com
M J
MJ
García González
A
A
Domínguez Rodríguez
R
R
Santacreu Iniesta
S
S
Samimi-Fard
J J
JJ
Ferrer Hita
C
C
Rubio-Iglesias García
P
P
Abreu González
D000368:Aged; D000800:Angioplasty, Balloon; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009203:Myocardial Infarction / Q000150:complications* / Q000628:therapy*; D011379:Prognosis; D011446:Prospective Studies; D018746:Systemic Inflammatory Response Syndrome / Q000150:complications* / Q000453:epidemiology*