| Clinical and angiographic predictors of ST-segment recovery after primary percutaneous coronary intervention. | |
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MedLine Citation:
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PMID: 20538116 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Important determinants of incomplete ST-segment recovery in patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) have been incompletely characterized. Early risk stratification could identify patients with STEMI and incomplete ST-segment recovery who may benefit from adjunctive therapy. For the present study, we analyzed 12-lead electrocardiograms from 2,124 patients with STEMI who underwent primary PCI at our institution from 2000 to 2007. ST-segment recovery was defined as percent change in cumulative ST-segment deviation between preprocedural and immediately postprocedural electrocardiograms and categorized as incomplete when <50%. A total of 1,032 patients (49%) had incomplete ST-segment recovery. After multivariable adjustment, age >60 years (adjusted odds ratio [OR] 1.28, 95% confidence interval [CI] 1.06 to 1.54, p = 0.011), diabetes mellitus (OR 1.36, 95% CI 1.02 to 1.82, p = 0.034), left anterior descending coronary artery-related STEMI (OR 1.92, 95% CI 1.61 to 2.30, p<0.001), and multivessel disease (OR 1.34, 95% CI 1.10 to 1.63, p = 0.004) were independent predictors of incomplete ST-segment recovery. Current smoking (OR 0.79, 95% CI 0.65 to 0.95, p = 0.013) and a preprocedural Thrombolysis In Myocardial Infarction grade <3 flow (OR 0.70, 95% CI 0.53 to 0.93, p = 0.014) were inversely related to ST-segment recovery. Incomplete ST-segment recovery was a strong predictor of long-term mortality (hazard ratio 2.07, 95% CI 1.59 to 2.69, p <0.001) in addition to identified characteristics that independently predicted incomplete ST-segment recovery. In conclusion, incomplete ST-segment recovery at the end of PCI occurred significantly more often in the presence of an age >60 years, nonsmoking, diabetes mellitus, left anterior descending coronary artery-related STEMI, multivessel disease, and preprocedural Thrombolysis In Myocardial Infarction grade 3 flow. Patients with STEMI and these clinical features are at increased risk of impaired myocardial salvage and are appropriate candidates for adjunctive therapy. |
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Authors:
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Niels J W Verouden; Joost D E Haeck; Wichert J Kuijt; Martijn Meuwissen; Karel T Koch; José P S Henriques; Jan Baan; Marije M Vis; Jan J Piek; Jan G P Tijssen; Robbert J de Winter |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2010-04-27 |
Journal Detail:
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Title: The American journal of cardiology Volume: 105 ISSN: 1879-1913 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-06-11 Completed Date: 2010-07-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1692-7 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiology, University of Amsterdam, Amsterdam, The Netherlands. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Angioplasty, Transluminal, Percutaneous Coronary* Coronary Angiography* Coronary Circulation / physiology* Electrocardiography* Female Follow-Up Studies Humans Male Middle Aged Myocardial Infarction / physiopathology, radiography, therapy* Prognosis Recovery of Function / physiology* Retrospective Studies |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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