La insuficiencia cardiaca sigue siendo una complicación muy frecuente en el curso del infarto agudo de miocardio pese a que su incidencia ha disminuido en los últimos años. La combinación de estas 2 entidades implica muy mal pronóstico y cuadruplica la mortalidad de los pacientes que la presentan. En un tercio de los infartos, la insuficiencia cardiaca aparece tras el ingreso hospitalario, y son precisamente estos pacientes los que presentan el peor pronóstico. Por tanto, la detección precoz de los enfermos con más riesgo (ancianos, taquicárdicos, diabéticos) es fundamental para emplear en ellos las medidas terapéuticas más enérgicas que puedan prevenir esta temible complicación. El pronóstico de los pacientes con insuficiencia cardiaca es peor cuanto mayor grado de disfunción ventricular presentan, pero la disfunción ventricular es también un determinante de mal pronóstico por sí misma, incluso en ausencia de insuficiencia cardiaca clínica.
Palabras clave
Infarto de miocardio
Insuficiencia cardiaca
Disfunción ventricular izquierda
Este artículo solo puede leerse en
pdf
Bibliografía
[1.]
L. Caruana, M.C. Petrie, A.P. Davie, J.V.C. McMurray.
Do patients with suspected heart failure and preserved left ventricular systolic function suffer from ≪diastolic heart failure≫ or from misdiagnosis? A prospective descriptive study.
BMJ, (2000), 321 pp. 215-218
[2.]
J.P. Hellermann, S.J. Jacobsen, B.J. Gersh, R.J. Rodeheffer, G.S. Reeder, V.L. Roger.
Heart failure after myocardial infarction: a review.
Am J Med, (2002), 113 pp. 341-343
[3.]
F. Grigioni, D. Detaint, J.F. Avierinos, C. Scott, J. Tajik, M. Enríquez-Sarano.
Contribution of ischemic mitral regurgitation to congestive heart failure after myocardial infarction.
J Am Coll Cardiol, (2005), 45 pp. 260-267
[4.]
M. Pfisterer.
Right ventricular involvement in myocardial infarction and cardiogenic shock.
Lancet, (2003), 362 pp. 392-394
[5.]
L.A. Zornoff, H. Skali, M.A. Pfeffer, M. St John Sutton, J.L. Rouleau, G.A. Lamas, et al.
SAVE Investigators. Right ventricular dysfunction and risk of heart failure and mortality after myocardial infarction.
J Am Coll Cardiol, (2002), 39 pp. 1450-1455
[6.]
E.J. Velázquez, G.S. Francis, P.W. Armstrong, P.E. Aylward, R. Díaz, C.M. O’Connor, et al.
An international perspective on heart failure and left ventricular systolic dysfunction complicating myocardial infarction: the VALIANT registry.
Eur Heart J, (2004), 25 pp. 1911-1919
[7.]
P.G. Steg, O.H. Dabbous, L.J. Feldman, A. Cohen-Solal, M.C. Aumont, J. López-Sendón, et al.
Determinants and prognostic impact of heart failure complicating acute coronary syndromes: observations from the Global Registry of Acute Coronary Events (GRACE).
Circulation, (2004), 109 pp. 494-499
[8.]
F.A. Spencer, T.E. Meyer, R.J. Goldberg, J. Yarzebski, M. Hatton, D. Lessard, et al.
Twenty years trends (1975-1995) in the incidence, in-hospital and long-term death rates associated with heart failure complicating acute myocardial infarction.
J Am Coll Cardiol, (1999), 34 pp. 1378-1387
[9.]
A.S. Ali, B.A. Rybicki, M. Alam, N. Wulbrecht, K. Richer-Cornish, Khaja, et al.
Clinical predictors of heart failure in patients with first acute myocardial infarction.
Am Heart J, (1999), 138 pp. 1133-1139
[10.]
P.H. Stone, J.E. Muller, T. Hartwell, B.J. York, J.D. Rutherford, C.B. Parker, et al.
The effect of diabetes mellitus on prognosis and serial left ventricular function after acute myocardial infarction: contribution of both coronary disease and diastolic left ventricular dysfunction to the adverse prognosis.
J Am Coll Cardiol, (1989), 14 pp. 49-57
[11.]
C.M. O’Connor, W.R. Hathaway, E.R. Bates, J.D. Leimberg, K.N. Sigmon, D.J. Kereiakes, et al.
Clinical characteristics and long-term outcome of patients in whom congestive heart failure develops after thrombolytic therapy for acute myocardial infarction: development of a predictive model.
Am Heart J, (1997), 133 pp. 663-673
[12.]
L. Kober, C. Torp-Pedersen, M. Ottesen, H. Burchardt, E. Korup, K. Lyngborg.
Influence of age on the prognostic importance of left ventricular dysfunction and congestive heart failure on longterm survival after acute myocardial infarction. TRACE study group.
Am J Cardiol, (1996), 78 pp. 158-162
[13.]
D. Hasdai, E.J. Topol, R. Kilaru, A. Battler, R.A. Harrington, A. Vahanian, et al.
Frequency, patient characteristics, and outcomes of mild-to-moderate heart failure complicating ST-segment elevation acute myocardial infarction: lessons from 4 international fibrinolytic therapy trials.
Am Heart J, (2003), 145 pp. 73-79
[14.]
Myocardial Infarction Redefined.
A Consensus Document of The Joint European Society of Cardiology/American College of Cardiology Committee for the Redefinition of Myocardial Infarction. The Joint European Society of Cardiology/American College of Cardiology Committee.
J Am Coll Cardiol, (2000), 36 pp. 959-969
[15.]
F.A. Spencer, T.E. Meyer, J.M. Gore, R.J. Goldberg.
Heterogeneity in the management and outcomes of patients with acute myocardial infarction complicated by heart failure: the National Registry of Myocardial Infarction.
Circulation, (2002), 105 pp. 2605-2610
[16.]
S.M. Macín, E.R. Perna, N. Augier, J. Cialzeta, E.F. Farías, M. Fontana, et al.
Características clínicas y evolución a largo plazo de pacientes con insuficiencia cardiaca como complicación del infarto agudo de miocardio.
Rev Esp Cardiol, (2005), 58 pp. 789-796
[17.]
The GUSTO Investigators.
An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction.
N Engl J Med, (1993), 329 pp. 673-682
[18.]
The Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO IIb) Investigators.
A comparison of recombinant hirudin with heparin for the treatment of acute coronary syndromes.
N Engl J Med, (1996), 335 pp. 775-782
[19.]
The Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO III) Investigators.
A comparison of reteplase with alteplase for acute myocardial infarction.
N Engl J Med, (1997), 337 pp. 1118-1123
[20.]
Assessment of the Safety Efficacy of a New Thrombolytic (ASSENT-2) Investigators Single-bolus tenecteplase compared with front-loaded alteplase in acute myocardial infarction: the ASSENT-2 double-blind randomised trial.
Lancet, (1999), 354 pp. 716-722
[21.]
T. Killip 3rd, J.T. Kimball.
Treatment of myocardial infarction in a coronary care unit. A two year experience with 250 patients.
Am J Cardiol, (1967), 20 pp. 457-464
[22.]
J.S. Hochman, C.E. Buller, L.A. Sleeper, J. Boland, V. Dzavik, T.A. Sanborn, et al.
Cardiogenic shock complicating acute myocardial infarction: etiologies, management and outcome: a report from the SHOCK Trial Registry. SHould we emergently revascularize Occluded Coronaries for cardiogenic shocK?.
J Am Coll Cardiol, (2000), 36 pp. 1063-1070
[23.]
J.G. Webb, L.A. Sleeper, C.E. Buller, J. Boland, A. Palazzo, E. Buller, et al.
Implications of the Timing of Onset of Cardiogenic Shock After Acute Myocardial Infarction: a Report from the SHOCK Trial Registry.
J Am Coll Cardiol, (2000), 36 pp. 1084-1090
[24.]
F. Arós, J. Cunat, A. Loma-Osorio, E. Torrado, X. Bosch, J.J. Rodríguez, et al.
Tratamiento del infarto agudo de miocardio en España en el año 2000. El estudio PRIAMO II.
Rev Esp Cardiol, (2003), 56 pp. 1165-1173
[25.]
N.R. Every, P.D. Frederick, M. Robinson, J. Sugarman, L. Bowlby, H.V. Barron.
A comparison of the national registry of myocardial infarction 2 with the cooperative cardiovascular project.
J Am Coll Cardiol, (1999), 33 pp. 1886-1894
[26.]
P. Nicod, E. Gilpin, H. Dittrich, F. Chappuis, S. Ahnve, R. Engler, et al.
Influence on prognosis and morbidity of left ventricular ejection fraction with and without signs of left ventricular failure after acute myocardial infarction.
Am J Cardiol, (1988), 61 pp. 1165-1171
[27.]
H. Emanuelsson, B.W. Karlson, J. Herlitz.
Characteristics and prognosis of patients with acute myocardial infarction in relation to occurrence of congestive heart failure.
Eur Heart J, (1994), 15 pp. 761-768
[28.]
H. Persson, E. Linder-Klingsell, S.V. Erikson, L. Erhardt.
Heart failure after myocardial infarction: the importance of diastolic dysfunction. A prospective clinical and echocardiographic study.
Eur Heart J, (1995), 16 pp. 496-505
[29.]
E. Lichstein, W.D. Hager, J.J. Gregory, J.L. Fleiss, L.M. Rolnitzky, J.T. Bigger Jr..
Relation between beta-adrenergic blocker use, various correlates of left ventricular function and the chance of developing congestive heart failure. The Multicenter Diltiazem Post-Infarction Research Group.
J Am Coll Cardiol, (1990), 16 pp. 1327-1332
[30.]
D. Hasdai, D.R. Holmes Jr, R.M. Califf, T.D. Thompson, J.S. Hochman, M. Pfisterer, et al.
Cardiogenic shock complicating acute myocardial infarction: predictors of death. GUSTO Investigators. Global utilization of streptokinase and tissue-plasminogen activator for occluded coronary arteries.
Am Heart J, (1999), 138 pp. 21-31
[31.]
M.G. Lindholm, L. Kober, S. Boesgaard, C. Torp-Pedersen, J. Aldershvile.
Trandolapril Cardiac Evaluation study group Cardiogenic shock complicating acute myocardial infarction; prognostic impact of early and late shock development.
Eur Heart J, (2003), 24 pp. 258-265
[32.]
U.C. Guidry, J.C. Evans, M.G. Larson, P.W.F. Wilson, J.M. Murabito, D. Levy.
Temporal trends in event rates after Q-wave myocardial infarction. The Framingham Heart Study.
Circulation, (1999), 100 pp. 2054-2059
[33.]
J.P. Hellermann, T.Y. Goraya, S.J. Jacobsen, S.A. Weston, G.S. Reeder, B.J. Gersh, et al.
Incidence of heart failure after myocardial infarction: is it changing over time?.
Am J Epidemiol, (2003), 157 pp. 1101-1107
[34.]
J.P. Hellermann, S.J. Jacobsen, M.M. Redfield, G.S. Reeder, S.A. Weston, V.L. Roger.
Heart failure after myocardial infarction: clinical presentation and survival.
Eur J Heart Fail, (2005), 7 pp. 119-125
[35.]
K.P. Alexander, M.T. Roe, A.Y. Chen, B.L. Lytle, C.V. Pollack, J.M. Foody, et al.
Evolution in cardiovascular care for elderly patients with non-ST-segment elevation acute coronary syndromes. Results from the CRUSADE national quality improvement initiative.
J Am Coll Cardiol, (2005), 46 pp. 1479-1487
[36.]
J.E. Moller, K. Egstrup, L. Kober, S.H. Poulsen, O. Nyvad, C. Torp-Pedersen.
Prognostic importance of systolic and diastolic function after acute myocardial infarction.
Am Heart J, (2003), 145 pp. 147-153
[37.]
J.P. Hellermann, S.J. Jacobsen, G.S. Reeder, F. López-Jiménez, S.A. Weston, V.L. Roger, et al.
Heart failure after myocardial infarction: Prevalence of preserved left ventricular systolic function in the community.
Am Heart J, (2003), 145 pp. 742-748
[38.]
J. Muñiz, J.J. Gómez, M.I. Santiago, E. De Teresa, J.M. Cruz, A. Castro.
Efecto de un programa sencillo de educación de los profesionales en el cumplimento de medidas de prevención secundaria en el momento del alta hospitalaria tras un síndrome coronario agudo. Proyecto CAM.
Rev Esp Cardiol, (2004), 57 pp. 1017-1028
[39.]
L. Kober, C. Torp-Pedersen, O.D. Pedersen, S. Hoiberg, A.J. Camm, On behalf of the TRACE study group.
Importance of congestive heart failure and interaction of congestive heart failure and left ventricular systolic function on prognosis in patients with acute myocardial infarction.
Am J Cardiol, (1996), 78 pp. 1124-1128
[40.]
J.G.F. Cleland, A. Torabi, N.K. Khan.
Epidemiology and management of heart failure and left ventricular systolic dysfunction in the aftermath of a myocardial infarction.
Heart, (2005), 91 pp. 7-13
[41.]
B. Pitt, W. Remme, F. Zannad, J. Neaton, F. Martínez, B. Roniker, et al.
Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction.
N Engl J Med, (2003), 348 pp. 1309-1321
[42.]
M.A. Pfeffer, J.J. McMurray, E.J. Velázquez, J.L. Rouleau, L. Køber, A.P. Maggioni, et al.
Valsartan, captopril or both in myocardial infarction complicated by heart failure, left ventricular dysfunction, or both.
N Eng J Med, (2003), 349 pp. 1893-1906
Copyright ©
2006. Sociedad Española de Cardiología