Steroids and myocardial infarction: Investigating safety and short-term mortality in critical post-myocardial infarction patients.
Am J Med Sci
; 368(1): 40-47, 2024 Jul.
Article
em En
| MEDLINE
| ID: mdl-38395147
ABSTRACT
BACKGROUND:
Conventionally, in the pre-percutaneous intervention era, free wall rupture is reported to be a major concern for using steroids in myocardial infarction (MI) patients. Therefore, the aim of this study was to evaluate the safety of the use of steroids in critically ill post-MI patients in terms of hospital course and short-term (up to 180-day) mortality.METHODS:
We included patients admitted to CCU diagnosed with MI, undergone revascularization, critically ill, and requiring mechanical ventilator (MV) support. The hospital course and short-term (up to 180-day) mortality were independently compared between steroid and non-steroid cohorts and propensity-matched non-steroid cohorts.RESULTS:
A total of 312 patients were included, out of which steroids were used in 93 (29.8%) patients during their management. On periodic bedside echocardiography, no free wall rupture was documented in the steroid or non-steroid cohort. When compared steroids with a propensity-matched non-steroid cohort, MV duration >24 h was 66.7% vs. 59.1%; p = 0.288, major bleeding was 6.5% vs. 3.2%; p = 0.305, need for renal replacement therapy was 9.7% vs. 8.6%; p = 0.799, in-hospital mortality was 35.5% vs. 23.7%; p = 0.077, and 180-day mortality was 48.4% vs. 41.9%; p = 0.377, respectively. The hazard ratio was 1.22 [95% CI 0.80 to 1.88] compared to the propensity-matched non-steroid cohort. The ejection fraction (%) was found to be the independent predictor of 180-day mortality with an adjusted odds ratio of 0.92 [95% CI 0.86 to 0.98].CONCLUSIONS:
In conclusion, using steroids is safe in post-MI patients with no significant increase in short-term mortality risk.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Esteroides
/
Infarto do Miocárdio
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article