Factors determining an unfavorable one-year prognosis of myocardial infarction complicated by left ventricular failure and associated with chronic cerebral ischemia

Abstract

Aim. To evaluate factors of unfavorable annual prognosis of myocardial infarction (MI) complicated by heart failure (HF) with reduced ejection fraction (HFrEF) and associated with chronic cerebral ischemia (CCI).Material and Methods. A total of 182 patients with Q wave myocardial infarction complicated by the left ventricular dysfunction concomitant with CCI were included in the study. Of them, 149 (81.9%) patients were men and 33 (18.1%) were women. The mean age was 60.4 (53; 69) years. All patients underwent echocardiography, color duplex scanning of the carotid arteries and examination by an interventional neurologist. Hard endpoints were collected within one year.Results. The majority of the patients included in the study suffered from grade 2 CCI. Atherosclerotic plaques in the brachiocephalic arteries were found in 37.4% of patients; the degree of stenosis did not exceed 50% in all cases. 77 (46.1%) patients achieved hard endpoints within one year. Multivariate logistic regression showed that the most unfavorable predictor of poor 1-year survival was the presence of the positive history of ACVA [RR 7.33 (95% CI 1.97–27.32), p = 0.003], and the most unfavorable predictors of risk of adverse cardiovascular events included prior stroke [RR = 1.92 (95% CI 1.09–3.38), p = 0.025] and carotid atherosclerotic plaques [RR = 2.12 (95% CI 1.34–3.37), p = 0.001].Conclusion. The presence of carotid atherosclerotic plaques and prior stroke affected the long-term prognosis in patients with myocardial infarction complicated by heart failure and chronic cerebral ischemia.