| Comparison of the prognostic effect of left versus right versus no bundle branch block on presenting electrocardiogram in acute myocardial infarction patients treated with primary angioplasty in the primary angioplasty in myocardial infarction trials. | |
| | |
MedLine Citation:
|
PMID: 16098297 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
The presence of bundle branch block (BBB) has been associated with poor outcomes in patients who have acute myocardial infarction. Whether this is true in the angioplasty era is not known. We sought to evaluate the outcome of patients with acute myocardial infarction and BBB who were treated with primary angioplasty. We evaluated 3,053 patients who underwent emergency catheterization in the PAMI trials. Patients who had left BBB (n = 48, 1.6%) on presenting electrocardiogram were compared with patients who had right BBB (n = 95, 3.1%) or no BBB (n = 2,910, 95.3%). Patients who had BBB were older and more frequently had diabetes mellitus, peripheral vascular disease, and previous coronary artery bypass grafting. They had lower ejection fraction and more multivessel disease. There were no significant differences in door-to-balloon time, final Thrombolysis In Myocardial Infarction flow grade or stent use. In-hospital major adverse cardiac events (death, ischemic target vessel revascularization, and reinfarction) were higher in patients who had BBB due primarily to increased in-hospital death (left BBB 14.6%, right BBB 7.4%, no BBB 2.8%, p < 0.0001). In multivariate logistic regression analysis, left BBB was an independent predictor of in-hospital death (odds ratio 5.53, 95% confidence interval 1.89 to 16.1, p = 0.002). In conclusion, patients who have acute myocardial infarction and BBB have increased co-morbidities and higher mortality rates despite treatment with primary angioplasty. Despite early identification of multivessel disease with triage to angioplasty or coronary artery bypass grafting, if necessary, similar treatment times, and final Thrombolysis In Myocardial Infarction grade 3 flow, the presence of left BBB on admission electrocardiogram in patients who have acute myocardial infarction is an independent predictor of in-hospital mortality. Because 85% of deaths in patients who have left BBB occur within the first week, these patients should be recognized early and receive prompt and aggressive treatment. |
| | |
Authors:
|
Mayra Guerrero; Kishore Harjai; Gregg W Stone; Bruce Brodie; David Cox; Judy Boura; Lorelei Grines; William O'Neill; Cindy Grines |
Related Documents
:
|
2733537 - Laser recanalization of pyloric stenosis: a guidewire-directed contact probe technique. 8968677 - Incremental value of myocardial perfusion scintigraphy in prognosis and outcomes of pat... 17045677 - Outcome of primary angioplasty for st-segment elevation myocardial infarction during ro... 2590587 - The epicardial electrogram: a quantitative assessment during balloon angioplasty incorp... 16036027 - How should comet influence heart failure practice? 6610347 - Electrophysiologic effects of bepridil in the anesthetized dog studied by endocardiac e... |
Publication Detail:
|
Type: Comparative Study; Journal Article |
Journal Detail:
|
Title: The American journal of cardiology Volume: 96 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2005 Aug |
Date Detail:
|
Created Date: 2005-08-15 Completed Date: 2005-09-15 Revised Date: 2006-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
|
Languages: eng Pagination: 482-8 Citation Subset: AIM; IM |
Affiliation:
|
William Beaumont Hospital, Royal Oak, Michigan, USA. mguerrero@beaumont.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Angioplasty, Transluminal, Percutaneous Coronary* / methods Bundle-Branch Block / diagnosis*, mortality, therapy Cause of Death Comorbidity Electrocardiography* Female Follow-Up Studies Hospital Mortality / trends Humans Inpatients Male Middle Aged Multivariate Analysis Myocardial Infarction / diagnosis*, mortality, therapy Prognosis Time Factors Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Impact of in-hospital acquired thrombocytopenia in patients undergoing primary angioplasty for acute...
Next Document: Prognostic usefulness of serum uric acid after acute myocardial infarction (the Japanese Acute Coron...