title: Evaluation of 5-year risk of cardiovascular events in patients after acute myocardial infarction using synchronization of 0.1-Hz rhythms in cardiovascular system.
abstract: BACKGROUND
  Synchronization between 0.1-Hz rhythms in cardiovascular system is deteriorated at acute myocardial infarction (AMI) leading to a disruption of natural functional couplings within the system of autonomic regulation.
  
  
  OBJECTIVE
  This study evaluates the prognostic value of autonomic regulation indices for the 5-year risk of fatal and nonfatal cardiovascular events in patients after AMI.
  
  
  RESULTS
  We studied 125 patients (53 [42%] female) after AMI aged between 30 and 83 years. The period of observation was 5 years with checkpoints at the first week after AMI and after each year after AMI. We compared the prognostic value of established clinical characteristics and degree S of synchronization between 0.1-Hz rhythms in heart rate and microcirculation for evaluation of the 5-year risk of mortality and recurrent myocardial infarction (MI) in patients after AMI. Acute heart failure Killip 2-4 at AMI and S < 20% at the first week after AMI were identified as the most important factors for evaluation of the risk of 5-year mortality in patients after AMI (χ(2) = 14.2, P = 0.003). Sensitivity and specificity of low S (<20%) at the first week after AMI were 76% and 43%, respectively. For evaluation of the 5-year risk of recurrent MI index S had no advantage over established clinical characteristics.
  
  
  CONCLUSIONS
  The value of S below 20% in patients with AMI is a sensitive marker of high risk of mortality during the subsequent five years. It is characterized by better prognostic value than most of established clinical characteristics.
authors: Center of New Cardiological Informational Technologies, Saratov Research Institute of Cardiology, Saratov, Russia. antonkis@list.ru
authors: Anton R
authors: AR
authors: Kiselev
authors: Vladimir I
authors: VI
authors: Gridnev
authors: Mikhail D
authors: MD
authors: Prokhorov
authors: Anatoly S
authors: AS
authors: Karavaev
authors: Olga M
authors: OM
authors: Posnenkova
authors: Vladimir I
authors: VI
authors: Ponomarenko
authors: Boris P
authors: BP
authors: Bezruchko
authors: Vladimir A
authors: VA
authors: Shvartz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality*; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D002423:Cause of Death; D015331:Cohort Studies; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D009203:Myocardial Infarction / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D016017:Odds Ratio; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012372:ROC Curve; D012008:Recurrence; D018570:Risk Assessment; D016019:Survival Analysis; D013997:Time Factors