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Comparison of Prognostic Outcome Between Left Circumflex Artery-Related and Right Coronary Artery-Related Acute Inferior Wall Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention.
MedLine Citation:
PMID:  21432857     Owner:  NLM     Status:  Publisher    
BACKGROUND: This study evaluated the 30-day clinical outcome of patients with acute inferior wall ST-elevation myocardial infarction (AIW-STEMI) from occlusion of the left circumflex artery (LCX) vs the right coronary artery (RCA) undergoing primary percutaneous coronary intervention (PCI). HYPOTHESIS: The clinical outcomes of AIW-STEMI caused by RCA and LCX occlusion may be different for patients undergoing primary PCI. METHODS: Between May 2002 and September 2009, 646 consecutive patients with AIW-STEMI undergoing primary PCI were enrolled. Of these patients, 520 (80.5%) with AIW-STEMI caused by RCA occlusion were categorized into group 1, whereas the remaining 126 (19.5%) whose AIW-STEMI was caused by LCX occlusion served as group 2. RESULTS: The results demonstrated that the frequency of advanced congestive heart failure, respiratory failure requiring mechanical ventilatory support, and 30-day mortality were remarkably higher in group 2 than in group 1 (all P < 0.01). Conversely, the incidence of right ventricular infarction and complete heart block were notably higher in group 1 than in group 2 (all P < 0.001). Additionally, the peak level of creatine kinase-isoenzyme MB was significantly higher, whereas the left ventricular ejection fraction was notably lower in group 2 than in group 1. Multivariate analysis demonstrated that advanced CHF, high serum creatinine level, low systolic blood pressure, low left ventricular ejection fraction, and LCX as the infarct-related artery were significantly and independently predictive of 30-day mortality (all P < 0.05). CONCLUSIONS: The 30-day prognostic outcome was less favorable in LCX-related AIW-STEMI compared with RCA-related AIW-STEMI undergoing primary PCI. Copyright © 2011 Wiley Periodicals, Inc. Chi-Ling Hang, MD, contributed equally in this study with Yung-Lung Chen, MD. Morgan Fu, MD, contributed equally in this study with Hon-Kan Yip, MD. The authors have no funding, financial relationships, or conflicts of interest to disclose.
Yung-Lung Chen; Chi-Ling Hang; Hsiu-Yu Fang; Tzu-Hsien Tsai; Cheuk-Kwan Sun; Chien-Jen Chen; Shyh-Ming Chen; Cheng-Hsu Yang; Yuan-Kai Hsieh; Chiung-Jen Wu; Morgan Fu; Hon-Kan Yip
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-1
Journal Detail:
Title:  Clinical cardiology     Volume:  -     ISSN:  1932-8737     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-3-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 Wiley Periodicals, Inc.
Division of Cardiology, Department of Internal Medicine (Y.-L. Chen, Hang, Fang, Tsai, C.-J. Chen, S.-M. Chen, Yang, Hsieh, Wu, Fu, Yip).
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