To review the literature on risk stratification after acute myocardial infarction in the reperfusion era and to propose an algorithm for early and continual risk assessment.
A MEDLINE search of the English-language literature on humans was done using the terms myocardial infarction, prospective studies, and prognosis.
This search was supplemented by narrowed searches for subheadings (such as cardiogenic shock, thrombolytic therapy, and stress testing) and surveys of references cited in review articles and book chapters.
Literature on prognosis and myocardial infarction published from 1981 to 1996 was considered.
From the literature on stress testing methods, studies that enrolled patients before 1980, enrolled patients for indications other than myocardial infarction, tested patients more than 6 weeks after infarction, were missing outcome data, or had inadequate follow-up were excluded.
Because too few randomized trials were available to allow the cross-comparison of risk-stratification methods, the available observational data were synthesized and supplemented with clinical judgments to produce recommendations.
Risk stratification must begin when acute myocardial infarction is diagnosed.
High-risk patients (such as those with cardiogenic shock) and candidates for reperfusion therapy must be identified quickly if ideal emergency care is to be given. (...)
Mots-clés Pascal : Infarctus, Myocarde, Facteur risque, Stratification, Unité soin intensif, Arbre décision, Base donnée répartie, Médecine, Multidisciplinaire, Prédisposition, Evaluation, Rapport coût bénéfice, Métaanalyse, Article synthèse, Recommandation, Homme, Pronostic, Appareil circulatoire pathologie, Cardiopathie coronaire, Myocarde pathologie, Organisation santé, Economie santé
Mots-clés Pascal anglais : Infarct, Myocardium, Risk factor, Stratification, Intensive care unit, Decision tree, Distributed database, Medicine, Multidisciplinary, Predisposition, Evaluation, Cost benefit ratio, Metaanalysis, Review, Recommendation, Human, Prognosis, Cardiovascular disease, Coronary heart disease, Myocardial disease, Public health organization, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0235140
Code Inist : 002B12A05. Création : 11/06/1997.