Factors determining an unfavorable one-year prognosis of myocardial infarction complicated by left ventricular failure and associated with chronic cerebral ischemia

Aim . To evaluate factors of unfavorable annual prognosis of myocardial infarction (MI) complicated by heart failure (HF) with reduced ejection fraction (HFrEF) and associated with chronic cerebral ischemia (CCI). Material and Methods . A total of 182 patients with Q wave myocardial infarction complicated by the left ventricular dysfunction concomitant with CCI were included in the study. Of them, 149 (81.9%) patients were men and 33 (18.1%) were women. The mean age was 60.4 (53; 69) years. All patients underwent echocardiography, color duplex scanning of the carotid arteries and examination by an interventional neurologist. Hard endpoints were collected within one year. Results . The majority of the patients included in the study suffered from grade 2 CCI. Atherosclerotic plaques in the brachiocephalic arteries were found in 37.4% of patients; the degree of stenosis did not exceed 50% in all cases. 77 (46.1%) patients achieved hard endpoints within one year. Multivariate logistic regression showed that the most unfavorable predictor of poor 1-year survival was the presence of the positive history of ACVA [RR 7.33 (95% CI 1.97–27.32), p = 0.003], and the most unfavorable predictors of risk of adverse cardiovascular events included prior stroke [RR = 1.92 (95% CI 1.09–3.38), p = 0.025] and carotid atherosclerotic plaques [RR = 2.12 (95% CI 1.34–3.37), p = 0.001]. Conclusion . The presence of carotid atherosclerotic plaques and prior stroke affected the long-term prognosis in patients with myocardial infarction complicated by heart failure and chronic cerebral ischemia.