| Beneficial effect of reperfusion therapy beyond the preservation of left ventricular function in patients with acute ST-segment elevation myocardial infarction. | |
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MedLine Citation:
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PMID: 19604587 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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BACKGROUND: Reperfusion therapy has been shown to improve mortality in patients with acute ST-segment elevation myocardial infarction. However, in randomized clinical trials there was only a modest improvement in left ventricular ejection fraction with reperfusion therapy, despite a larger improvement in mortality. METHODS: In the prospective MITRA-Plus registry we compared 1-year mortality of inhospital survivors of ST-segment elevation myocardial infarction (STEMI) divided into nine groups with preserved (>55%), moderately reduced (41-55%) and severely reduced (≤40%) left ventricular ejection fraction (LVEF) and treated with no early reperfusion therapy, fibrinolysis or primary percutaneous coronary intervention (PCI) within 24h after admission. RESULTS: A total of 5867 patients were included in this analysis, 1026 (18%) without early reperfusion, 2462 (42%) with fibrinolysis and 2379 (40%) with primary PCI. After adjustment for confounding variables in a propensity score analysis, reperfusion therapy (Odds ratio and 95% CI: 0.27, 0.15-0.48; 0.50, 0.32-0.79; 0.64, 0.44-0.93), fibrinolysis (Odds ratio and 95% CI: 0.27, 0.14-0.52; 0.58, 0.35-0.95; 0.60, 0.39-0.93) and primary PCI (Odds ratio and 95% CI: 0.22, 0.11-0.44; 0.34, 0.19-0.59; 0.56, 0.36-0.88) remained independent predictors of survival in comparison to no reperfusion therapy in the patients with preserved, moderately reduced and severely reduced LVEF, respectively. CONCLUSIONS: These results suggest a beneficial effect of early reperfusion therapy beyond the preservation of left ventricular function, however the mechanisms need further study. |
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Authors:
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Uwe Zeymer; Timm Bauer; Bernard J Gersh; Ralf Zahn; Anselm Gitt; Claus Jünger; Jochen Senges |
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Publication Detail:
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Type: Journal Article Date: 2009-07-14 |
Journal Detail:
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Title: International journal of cardiology Volume: 146 ISSN: 1874-1754 ISO Abbreviation: Int. J. Cardiol. Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2011-01-17 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8200291 Medline TA: Int J Cardiol Country: Netherlands |
Other Details:
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Languages: eng Pagination: 177-80 Citation Subset: IM |
Copyright Information:
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Copyright © 2009 Elsevier Ireland Ltd. All rights reserved. |
Affiliation:
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Herzzentrum Ludwigshafen, Medizinische Klink B, Ludwigshafen, Germany; Institut für Herzinfarktforschung Ludwigshafen an der Universität Heidelberg, Ludwigshafen, Germany. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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