Document Detail


Comparison of effects of primary coronary angioplasty on left ventricular remodeling and heart failure in patients <70 versus > or =70 years with acute myocardial infarction.
MedLine Citation:
PMID:  19766758     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Experimental studies have demonstrated the adverse effects of senescence on cardiac function and remodeling after acute myocardial infarction (AMI). We sought to assess the impact of age on left ventricular (LV) remodeling and heart failure (HF) after successful primary angioplasty for AMI. A series of 512 consecutive patients underwent 2-dimensional echocardiography at admission and at 1 month and 6 months after index AMI. LV volumes, ejection fraction, and wall motion score index (WMSI) were measured. Patients were divided in group 1 (<70 years old, n = 361) and group 2 (> or =70 years old, n = 151). Group 2 patients showed a lower peak creatine kinase (p = 0.029) compared to group 1. In group 2 patients the 6-month prevalence of LV remodeling (increase >20% in end-diastolic volume) was higher (34% vs 25%, p = 0.041), recoveries of ejection fraction and WMSI were lower (p = 0.00002 for the 2 comparisons), and incidence of late HF was higher (35% vs 17%, p <0.0001) compared to group 1 patients. Independent predictors of LV remodeling were WMSI (p <0.0001), infarct size (p <0.0001), and LV end-diastolic volume (p <0.0001). Independent predictors of late HF were WMSI (hazard ratio [HR] 2.7, 95% confidence interval [CI] 1.624 to 4.514), 6-month LV dilation (HR 2.13, 95% CI 1.404 to 3.233), diabetes (HR 1.6, 95% CI 1.008 to 2.595), infarct size (HR 1.12, 95% CI 1.037 to 1.215), and age as continuous variables (HR 1.064, 95% CI 1.044 to 1.085). In conclusion, besides infarct size, extensive regional systolic dysfunction may play a significant role in the development of LV remodeling and HF in patients > or =70 years old after successful primary angioplasty.
Authors:
Nazario Carrabba; Guido Parodi; Renato Valenti; Angela Migliorini; David Antoniucci
Related Documents :
19395098 - Ventricular dysfunction in type 1 myotonic dystrophy: electrical, mechanical, or both?
17110808 - Acute effects of febuxostat, a nonpurine selective inhibitor of xanthine oxidase, in pa...
15041568 - Inotropes improve right heart function in patients undergoing aortic valve replacement ...
6945508 - The clinical significance of right ventricular infarction.
20815058 - Quantification of myocardial strain at early systole in mouse heart: restoration of und...
21821538 - Clinical efforts to reduce myocardial infarct size--the next step.
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  104     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-21     Completed Date:  2009-10-06     Revised Date:  2010-03-16    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  926-31     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, Careggi Hospital, Florence, Italy. carddept@tin.it
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Aged, 80 and over
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects,  methods*
Cohort Studies
Confidence Intervals
Coronary Angiography / methods
Coronary Circulation / physiology
Echocardiography, Doppler
Electrocardiography
Female
Follow-Up Studies
Heart Failure / epidemiology,  etiology,  ultrasonography*
Humans
Incidence
Male
Middle Aged
Myocardial Infarction / diagnosis*,  therapy*
Predictive Value of Tests
Probability
Proportional Hazards Models
Risk Assessment
Severity of Illness Index
Stroke Volume
Ventricular Remodeling / physiology*
Comments/Corrections
Comment In:
Am J Cardiol. 2010 Mar 15;105(6):903-4   [PMID:  20211345 ]

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


Previous Document:  Efficacy of single-bolus administration of sodium bicarbonate to prevent contrast-induced nephropath...
Next Document:  Relation of alcohol consumption and coronary heart disease in hypertensive male physicians (from the...