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[Disseminated intravascular coagulation syndrome in myocardial infarct]
Insights
Disseminated intravascular coagulation (DIC) is rare in acute myocardial infarction, occurring in less than 20% of patients, especially those with cardiogenic shock. Microcirculatory thrombosis, a precursor to DIC, is more common in females and linked to older age, hypertension, and diabetes.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Pathology
Context:
- Acute myocardial infarction (AMI) is a leading cause of mortality worldwide.
- Disseminated intravascular coagulation (DIC) is a complex syndrome that can complicate critical illnesses.
- Understanding the incidence and characteristics of DIC in AMI is crucial for patient management.
Purpose:
- To determine the incidence of disseminated intravascular coagulation (DIC) syndrome in patients who died from acute myocardial infarction (AMI).
- To investigate the timing, localization, and predisposing factors of microcirculatory thrombosis in AMI.
- To identify patient demographics and comorbidities associated with DIC development in AMI.
Summary:
- A clinical and anatomical analysis of 76 patients who died from AMI revealed DIC in 19.1% of those with cardiogenic shock.
- Microcirculatory thrombosis, a potential precursor to DIC, was observed in the first to second week of AMI, primarily in single organs (78.6%) and rarely in three or more organs (21.4%).
- Microcirculatory thrombosis was more frequent in females, and predisposing factors included old age, persistent hypertension, and diabetes mellitus.
Impact:
- This study highlights the low incidence of DIC in AMI, suggesting it is not a universal complication.
- Identifying predisposing factors like age, hypertension, and diabetes can aid in risk stratification for AMI patients.
- The findings emphasize the importance of considering microcirculatory thrombosis in the pathophysiology of AMI, particularly in specific patient groups.
Abstract:
To establish the incidence of the disseminated intravascular coagulation (DIC) syndrome, 76 patients who had died from acute myocardial infarction were clinically and anatomically analysed. The studies indicated that microcirculatory thrombosis in myocardial infarction occurred in the first to early second weeks of its development and localized in minor veins of one organ and only in 21.4% of cases it involved three organs or more. The DIC-syndrome was morphologically evidenced only in 19.1% of the patients having a history of cardiogenic shock. Microcirculatory thrombosis more frequently occurred in females. Old age, persistent hypertension, diabetes mellitus were found to predispose to its development.