Risk stratification and anticoagulation strategies for post-PCI management in acute myocardial infarction patients with severe left ventricular dysfunction
Keywords:
CHA2DS2-VASc score, embolus, HAS-BLED score, stroke, thrombotic eventsAbstract
Background: Acute myocardial infarction (AMI) can result in severe left ventricular dysfunction (LVD) and cardiac failure, increasing risk of complications like stroke, thrombo-embolism, and recurrent AMI. Appropriate anticoagulation strategies are crucial for mitigating adverse events. The risk stratification of these patients involves evaluating their propensity for thrombotic and hemorrhagic events. Objectives: The study determined risk stratification and anticoagulation strategies for AMI patients with severe LVD post-PCI. Methods: At a tertiary hospital in Peshawar Pakistan, an investigation was conducted on 300 patients who presented with anterior AMI and 40% LVEF upon admission. Group A received anticoagulant therapy as part of their post-PCI management, whereas Group B received standard post-PCI management without anticoagulant therapy. Various risk scores, including CHA2DS2-VASc and HAS-BLED score, and major adverse cardiovascular events, were used in assessing patient's risk of thrombosis events of bleeding through risk stratification. Results: Mean age of patients was 63.47+8.19 years, mean BMI was 28.76+3.0 and 193/300 (64.33%) were females. Hypertension, hyperlipidemia and diabetes were the prevailing comorbidities (p<0.05) among the subjects. CHA2DS2-VASc scores classified patients into low-risk group (29.33%), medium risk (59.66%) and high-risk cohort (11%).
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