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Coronary artery disease in patients clinically diagnosed with myocardial infarction in the medical intensive care unit.
MedLine Citation:
PMID:  23428709     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: The purpose of this study is to compare the clinical characteristics and outcomes of patients with and without coronary artery disease (CAD) confirmed by coronary angiography in critically ill patients clinically diagnosed with myocardial infarction. MATERIALS AND METHODS: This retrospective observational study involved 56 patients who were clinically diagnosed with myocardial infarction and subsequently underwent coronary angiography during their intensive care unit stay. RESULTS: Only 18 patients (32%) were finally confirmed to have CAD by coronary angiography. There were no significant differences in laboratory findings and clinical outcomes between patients with and without CAD. However, patients who developed shock (P = .009) and needed vasopressor support (P = .021) were less likely to be diagnosed with CAD. In addition, regional wall motion abnormality on echocardiography was more frequently observed in patients with CAD (P = .072). In a multiple logistic regression analysis, male sex (adjusted odds ratio [OR], 5.093; 95% confidence interval [CI], 1.177-22.037) and focal hypokinesia on echocardiography (adjusted OR, 5.134; 95% CI, 1.071-24.614) were independently associated with CAD. However, development of shock was inversely associated with CAD (adjusted OR, 0.107; 95% CI, 0.019-0.606). CONCLUSION: Coronary angiography in critically ill patients should only be performed in highly selected patients with predicting factors for CAD.
Authors:
Yousang Ko; Chi-Min Park; Wooyoul Kim; Byeong-Ho Jeong; Gee Young Suh; So Yeon Lim; O Jung Kwon; Kyeongman Jeon
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-2-18
Journal Detail:
Title:  Journal of critical care     Volume:  -     ISSN:  1557-8615     ISO Abbreviation:  J Crit Care     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-2-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8610642     Medline TA:  J Crit Care     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 Elsevier Inc. All rights reserved.
Affiliation:
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, 135-710, Republic of Korea.
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