Key result
AMI in acute pulmonary edema is linked to a ~40% absolute increase in hospital mortality.
Why the study?
What are the hospital and long-term survival rates and predictors of mortality in patients with acute pulmonary edema associated with coronary artery disease?
Cohort (n=44)
No
What are the hospital and long-term survival rates and predictors of mortality in patients with acute pulmonary edema associated with coronary artery disease?
Absolute Event Rate: 46% vs 6%
p-value: p=0.006
In patients with acute pulmonary edema and coronary artery disease, concurrent acute myocardial infarction drives high in-hospital mortality, whereas a history of congestive heart failure strongly predicts poor long-term survival.
AMI signals high in-hospital mortality risk in acute pulmonary edema; hypothesis-generating for risk stratification, pending prospective validation.
Cardiogenic acute pulmonary edema (APE) associated with coronary artery disease was diagnosed in 44 patients admitted over a 1-year period to a general university hospital. The patients' clinical characteristics at presentation were variable. Acute myocardial infarction (AMI) was present in 26 patients (59%). The hospital mortality rate was 46% (12 of 26 patients) in the presence of AMI and 6% (1 of 18) in its absence (p = 0.006). Long-term follow-up of all hospital survivors revealed that 8 of 30 (27%) had died at 1 year and that 21 of 30 patients (70%) had died at 6 years. However, there was no significant difference in subsequent survival between the AMI and non-AMI groups. A history of congestive heart failure was selected as the most important predictor of increased mortality risk by univariate analysis of the clinical characteristics of the hospital survivors (p = 0.02). The mortality rate at 6 years of follow-up was 85% (17 of 20 patients) in the presence of a history of congestive heart failure and 40% (6 of 10) in its absence.
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Wiener et al. (1987) conducted a cohort in Cardiogenic acute pulmonary edema associated with coronary artery disease (n=44). Acute myocardial infarction vs. Absence of acute myocardial infarction was evaluated on Hospital mortality (p=0.006). Acute myocardial infarction in patients with acute pulmonary edema was associated with higher hospital mortality compared to its absence (46% vs 6%, p=0.006).
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