Summary

Prognostic importance of cardiomegaly in patients with acute myocardial infarction

Jaulent-Huertas L, Consuegra-Sánchez L, Vicente-Gilabert M, Melgarejo-Moreno A, Alonso-Fernández N, Díaz-Pastor A, Escudero-García G, Galcerá-Tomás J

Affiliation of the authors

Servicio de Cardiología y Medicina Intensiva, Hospital Universitario de Santa Lucía, Cartagena, Murcia, Spain. Servicio de Medicina Intensiva, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain.

DOI

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Jaulent-Huertas L, Consuegra-Sánchez L, Vicente-Gilabert M, Melgarejo-Moreno A, Alonso-Fernández N, Díaz-Pastor A, et al. Prognostic importance of cardiomegaly in patients with acute myocardial infarction. Emergencias. 2015;27:294-300

Summary

Objectives.

To assess the in-hospital and long-term prognostic importance of cardiomegaly demonstrated by a simple admission radiograph in patients hospitalized for acute myocardial infarction.

Methods.

Prospective study of 7644 patients admitted for acute myocardial infarction; 2 hospitals participated. We recorded detailed clinical data, especially noting the presence or absence of cardiomegaly in the chest radiograph. Adjusted predictive models for all-cause mortality in hospital or after discharge were constructed. The median followup was 6 years.

Results.

Cardiomegaly was detected in 1351 (17.7%) of the patients. Hospital mortality was 11.2% overall; the incidence of long-term mortality was 5.7 per 100 patient-years. Patients with cardiomegaly were older and had more cardiovascular

risk factors other than current smoking; they also had more concomitant conditions, had undergone fewer revascularization procedures, and received suboptimal care after discharge. Cardiomegaly was associated with higher in-hospital rates of adverse events, especially heart failure (70.8% in patients with cardiomegaly vs 21.4% in

others, P<.001) and death (27.8% vs 7.7%, P<.001). Cardiomegaly was also an independent predictor of hospital mortality (odds ratio, 1.34; P=.02) as well as mortality after discharge (hazard ratio, 1.16; P<.01).

Conclusions.

Cardiomegaly was an independent predictor of both hospital mortality and long-term mortality after discharge in this series.

 

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Alonso-Fernández N, Consuegra-Sánchez L, Díaz-Pastor A, Escudero-García G, Galcerá-Tomás J, Jaulent-Huertas L, Melgarejo-Moreno A, Vicente-Gilabert M

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