Document Detail


Clinical and electrocardiographic correlates of normal coronary angiography in patients referred for primary percutaneous coronary intervention.
MedLine Citation:
PMID:  18602513     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study sought to determine the prevalence as well as clinical and electrocardiographic correlates of patients referred for primary percutaneous coronary intervention (PCI) who had angiographically normal coronary arteries. Data for 690 consecutive patients with ST-elevation myocardial infarction (STEMI) referred for primary PCI within a metropolitan area health service were reviewed. Characteristics of patients with angiographically normal coronary arteries (n = 87; 13%) were compared with patients with angiographically shown culprit lesions (control group; n = 594). Nine patients with significant coronary disease, but no identifiable culprit lesion, were excluded. Electrocardiograms (ECGs) from both groups were reviewed by 2 cardiologists blinded to angiographic findings. Patients in the normal coronaries group were younger and had fewer risk factors. On expert review of ECGs, 55% of patients in the normal coronaries group had ST-elevation criteria for STEMI (vs 93% in the control group; p <0.001), but the ECG was considered consistent with a diagnosis of STEMI by both observers in only 33% (vs 92% in the control group; p <0.001). Left branch bundle block independently correlated with normal coronary arteries on multivariate analysis (odds ratio for STEMI 0.016, 95% confidence interval 0.004 to 0.064, p <0.001). The discharge diagnosis in the normal coronaries group was predominantly pericarditis (n = 72; 83%). In conclusion, the prevalence of angiographically normal coronary arteries in patients referred for primary PCI was 13%. Electrocardiographic correlation suggested that this can be reduced by adherence to conventional electrocardiographic criteria for STEMI diagnosis and review of ECGs by experienced clinicians.
Authors:
Sandhir B Prasad; David A B Richards; Norman Sadick; Andrew T L Ong; Pramesh Kovoor
Related Documents :
20643243 - Impact of multivessel coronary artery disease and noninfarct-related artery revasculari...
19261993 - Long-term outcomes of intervention for unprotected left main coronary artery stenosis: ...
18940533 - Localization of atrial fibrillation triggers in patients undergoing pulmonary vein isol...
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-05-28
Journal Detail:
Title:  The American journal of cardiology     Volume:  102     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-07-07     Completed Date:  2008-08-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  155-9     Citation Subset:  AIM; IM    
Affiliation:
Westmead Hospital, Westmead, NSW, Australia. sprasad@bigpond.net.au
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Angioplasty, Transluminal, Percutaneous Coronary*
Bundle-Branch Block
Case-Control Studies
Coronary Angiography*
Coronary Artery Disease / diagnosis,  physiopathology*,  radiography,  therapy
Electrocardiography*
Female
Humans
Male
Middle Aged
Myocardial Infarction / diagnosis,  physiopathology*,  radiography,  therapy
Prospective Studies
Referral and Consultation
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Diabetes mellitus, hypothalamic hypoestrogenemia, and coronary artery disease in premenopausal women...
Next Document:  Bleeding risk and outcomes of Bivalirudin versus Glycoprotein IIb/IIIa inhibitors with targeted low-...