| 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. | |
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MedLine Citation:
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PMID: 19766758 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Nazario Carrabba; Guido Parodi; Renato Valenti; Angela Migliorini; David Antoniucci |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The American journal of cardiology Volume: 104 ISSN: 1879-1913 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-09-21 Completed Date: 2009-10-06 Revised Date: 2010-03-16 |
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: 926-31 Citation Subset: AIM; IM |
Affiliation:
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Division of Cardiology, Careggi Hospital, Florence, Italy. carddept@tin.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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Am J Cardiol. 2010 Mar 15;105(6):903-4
[PMID:
20211345
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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