| The initial anion gap is a predictor of mortality in acute myocardial infarction. | |
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MedLine Citation:
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PMID: 16845247 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To determine the relationship between the anion gap and outcomes in patients with acute myocardial infarction. METHODS: We assessed the relationship between the initial anion gap and in-hospital outcomes among consecutive acute myocardial infarction patients admitted to a single coronary care unit. The anion gap was calculated as [sodium-(chloride+CO2)]. Anion gap>12 was considered to represent anion gap acidosis. RESULTS: Complete data were available for 773 patients. Anion gap acidosis on admission was found in 90 patients (12%), and was more common among older patients (P=0.02), women (P=0.008), non-whites (P=0.04), and patients with diabetes (P=0.03), chronic renal failure (P<0.001), a lower glomerular filtration rate (P<0.001), and cardiogenic shock (P<0.001). In-hospital death occurred in 33% of patients with initial anion gap acidosis compared with 8% in those with a normal anion gap (P<0.001). On multivariate analysis, the presence of an initial anion gap acidosis was associated with the risk of death (odds ratio 4.2, 95% confidence interval 2.3-7.5, P<0.001), independent of other data available at the time of admission. The addition of ejection fraction to the model significantly attenuated this association. CONCLUSIONS: The admission anion gap provides important incremental information for initial risk stratification in acute myocardial infarction. |
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Authors:
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Anurag Sahu; Howard A Cooper; Julio A Panza |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Coronary artery disease Volume: 17 ISSN: 0954-6928 ISO Abbreviation: Coron. Artery Dis. Publication Date: 2006 Aug |
Date Detail:
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Created Date: 2006-07-17 Completed Date: 2006-11-28 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9011445 Medline TA: Coron Artery Dis Country: England |
Other Details:
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Languages: eng Pagination: 409-12 Citation Subset: IM |
Affiliation:
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Washington Hospital Center, Washington, District of Columbia 20010, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acid-Base Equilibrium* Acidosis* Acute Disease Aged Coronary Care Units / utilization District of Columbia Female Hospital Mortality* Humans Male Middle Aged Myocardial Infarction / mortality, physiopathology* Prognosis Treatment Outcome* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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