Document Detail


The initial anion gap is a predictor of mortality in acute myocardial infarction.
MedLine Citation:
PMID:  16845247     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Anurag Sahu; Howard A Cooper; Julio A Panza
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Coronary artery disease     Volume:  17     ISSN:  0954-6928     ISO Abbreviation:  Coron. Artery Dis.     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-07-17     Completed Date:  2006-11-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9011445     Medline TA:  Coron Artery Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  409-12     Citation Subset:  IM    
Affiliation:
Washington Hospital Center, Washington, District of Columbia 20010, USA.
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MeSH Terms
Descriptor/Qualifier:
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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