Tiên lượng tử vong ở bệnh nhân nhồi máu cơ tim cấp

1 MỞ ĐẦU

Ngày nay, nhồi máu cơ tim cấp vẫn là một trong những nguyên nhân chủ yếu gây tử vong

và tàn tật trên thế giới. Vào năm 2017, ước đoán 695.000 người Mỹ mới mắc NMCT cấp

và 325.000 người có biến cố NMCT tái phát [1].

Mặc dù điều trị sớm bằng tái tưới máu và thuốc đã góp phần giảm đáng kể tử vong sau

NMCT trong 30 năm qua [2,3] nhưng tỉ lệ tử vong trong bệnh viện vẫn còn cao hơn 4% và

có thể đạt đến hơn 30% ở một số phân nhóm. Hiểu các yếu tố liên quan tử vong sau

NMCT cấp có thể hướng dẫn quyết định điều trị cũng như cung cấp thông tin tiên lượng

quan trọng không những cho bác sĩ mà còn cho bệnh nhân và gia đình của họ. Ngoài ra,

các mô hình nguy cơ giúp tiên lượng và so sánh kết cục tử vong. Để tăng hiểu biết về nguy

cơ tử vong của bệnh nhân sau NMCT độc lập với điều trị, bài viết này tập trung vào những

thông tin sẵn có sớm sau khi khởi phát bệnh gồm các yếu tố nguy cơ chính của tử vongsau NMCT cấp (như yếu tố dân số, bệnh đồng mắc và đặc điểm lâm sàng và cận lâm

sàng) và các mô hình tiên lượng nguy cơ ở bệnh nhân NMCT cấp.

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