Document Detail


Clinical features and outcome of emergency percutaneous intervention of left main coronary artery occlusion in acute myocardial infarction.
MedLine Citation:
PMID:  18043840     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Acute myocardial infarction (AMI) due to left main coronary artery (LMCA) occlusion carries a grave prognosis. Large series reporting on the outcome of emergency revascularisation (percutaneous or surgical) of acute LMCA occlusion have been scarce. We seek to identify, in our local population, the clinical presentation and outcome of this group of patients. METHODS: From January 2000 to December 2005, a total of 1,539 patients underwent primary percutaneous coronary angioplasty for AMI in our institution. 11 patients (0.8 percent) underwent percutaneous intervention to the LMCA. These patients became the subjects of our study. Data on demography, clinical features and outcome was collected from all in-hospital and clinical notes. One sub-investigator, who was blinded to the study outcome, assessed the angiographical features. RESULTS: The overall inpatient mortality was 82 percent (9 out of 11). Nine out of 11 patients presented with cardiogenic shock. All patients presented with shock died during the hospital stay. All patients required intra-aortic balloon counter pulsation insertion. Of the two patients who survived till discharge, one had angioplasty followed by bypass surgery. The remaining one had angioplasty and stenting to the left main artery. Both survivors have been doing well without further major adverse cardiac event after an average of 64 months of follow-up. CONCLUSION: Percutaneous revascularisation of acute LMCA occlusion is feasible and the best outcome is seen in stable patients. Prognosis is still poor in patients with unfavourable clinical features.
Authors:
H C Tang; A Wong; P Wong; T S J Chua; T H Koh; S T Lim
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Singapore medical journal     Volume:  48     ISSN:  0037-5675     ISO Abbreviation:  Singapore Med J     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-11-28     Completed Date:  2008-01-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0404516     Medline TA:  Singapore Med J     Country:  Singapore    
Other Details:
Languages:  eng     Pagination:  1122-4     Citation Subset:  IM    
Affiliation:
Department of Cardiology, National Heart Centre, Mistri Wing, 17 Third Hospital Avenue, Singapore 168752. tang_hak_chiaw@nhc.com.sg
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aged
Angioplasty, Transluminal, Percutaneous Coronary / methods*,  mortality
Cohort Studies
Coronary Angiography
Coronary Stenosis / mortality*,  radiography,  therapy*
Emergency Treatment
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Infarction / mortality*,  radiography,  therapy*
Retrospective Studies
Risk Factors
Severity of Illness Index
Singapore
Stents
Survival Rate
Treatment Outcome

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


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