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Systemic Inflammatory Response Syndrome Predicts Mortality in Acute Coronary Syndrome without Congestive Heart
Matías José Fosco1, Victoria Ceretti, Daniel Agranatti
1Zubizarreta Hospital, Department of Emergency Medicine, Buenos Aires, Argentina.
Insights
Systemic Inflammatory Response Syndrome (SIRS) indicates higher hospital mortality risk in acute coronary syndrome (ACS) patients without heart failure. This finding aids in identifying high-risk ACS patients for better outcomes.
Area of Science:
- Cardiology
- Critical Care Medicine
- Inflammation Research
Background:
- Elevated inflammatory markers are linked to increased risk in acute coronary syndrome (ACS) patients.
- The prognostic value of Systemic Inflammatory Response Syndrome (SIRS) in ACS patients without congestive heart failure (CHF) requires evaluation.
Purpose of the Study:
- To assess the prognostic significance of SIRS in ACS patients.
- To determine if SIRS predicts hospital mortality in ACS patients without clinical or radiological evidence of CHF.
Main Methods:
- 196 consecutive ACS patients without CHF were included.
- Hospital mortality was the primary endpoint.
- Logistic regression analysis identified predictors of mortality.
Main Results:
- 11.2% of patients presented with SIRS upon emergency department admission.
- SIRS was a significant predictor of hospital mortality (OR 9, p=0.02).
- Other mortality predictors included age, systolic and diastolic blood pressure, and respiratory rate.
Conclusions:
- SIRS is a significant marker of increased hospital mortality risk in ACS patients.
- The study highlights the prognostic importance of SIRS in ACS patients without CHF.
- Early identification of SIRS may aid in risk stratification and management of ACS patients.
Introduction:
High levels of inflammatory biochemical markers are associated with an increased risk among patients with acute coronary syndrome (ACS). The objective of the current study was to evaluate the prognostic significance of the systemic inflammatory response syndrome (SIRS) among ACS patients with no clinical or radiological evidence of congestive heart failure (CHF).
Methods:
Consecutive patients with ACS and no clinical or radiological evidence of CHF in the emergency department (ED) were included in the study. The endpoint was hospital mortality. Categorical variables were compared by calculating proportions with 95% confidence intervals (CIs) and by using the Fisher Exact test. Continuous variables were compared by using the Wilcoxon Rank Sum test. The association of the variables with hospital mortality was assessed by using the logistic regression analysis.
Results:
The study included 196 patients (60 years; female 32.6 %). Six patients (3.1 %) died in hospital and 22 patients (11.2 %) had SIRS on admission to the ED. The following variables were predictors of hospital mortality: age with an odds ratio (OR) of 1.1 (95% CI, 1-1.2) for each one additional year (p <0.01), systolic arterial pressure with an OR 0.9 (95% CI, 0.9-1), diastolic arterial pressure with an OR 0.9 (95% CI, 0.8-1) for each one additional mmHg (p < 0.01), respiratory rate with an OR 1.5 (95% CI, 1.2-1.9) for each one additional breath per minute (p < 0.01), and SIRS with an OR 9 (95% CI, 1.7-47.8) (p 0.02). Because of the small number of events, it was not possible to assess the independence of these risk factors.
Conclusion:
SIRS was a marker of increased risk of hospital mortality among patients with ACS and no clinical or radiological evidence of CHF.
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