Document Detail

Determinants and prognostic significance of spontaneous coronary recanalization in acute myocardial infarction.
MedLine Citation:
PMID:  11305984     Owner:  NLM     Status:  MEDLINE    
Spontaneous recanalization (SR) occurs after the onset of acute myocardial infarction (AMI), but its clinical significance in the reperfusion era remains uncertain. We evaluated the determinants and prognostic significance of SR in 196 consecutive patients with AMI who underwent primary angioplasty at our institution. The study population was divided into 2 groups according to the presence (group I, n = 44) or absence (group II, n = 152) of SR (Thrombolysis In Myocardial Infarction [TIMI] anterograde > or = 2 flow on the preintervention angiogram). The primary end point was the occurrence, within 6-weeks after AMI, of death, nonfatal reinfarction, and congestive heart failure. Baseline characteristics were similar between the 2 groups. Peak levels of creatine kinase were lower in group I than in group II (2,500 +/- 1,800 vs 4,000 +/- 2,900 U/L, respectively, p < 0.05). The rate of TIMI flow grade 3 after intervention was higher in group I than in group II (93.2% vs 79.6%, respectively, p < 0.05), and patients in group I had a faster corrected TIMI frame count than those in group II (22.7 +/- 12.4 vs 30.3 +/- 22.8, respectively, p < 0.05). Preinfarction angina (odds ratio [OR] 2.18, 95% confidence interval [CI] 1.10 to 4.33, p < 0.05), heavy thrombi (OR 0.10, 95% CI 0.01 to 0.74, p < 0.05), and good angiographic collaterals (OR 0.12, 95% CI 0.02 to 0.89, p < 0.05) were independent predictors of SR. Death, reinfarction, and severe arrhythmia were not different between the 2 groups. However, heart failure occurred more frequently in group II than in group I (15.1% vs 2.3%, respectively, p < 0.05). The primary end point was also significantly lower in group I than in group II (4.5% vs 18.4%, respectively, p < 0.05). In conclusion, SR in AMI is associated with faster coronary flow, smaller infarct size, and a better clinical outcome after primary angioplasty.
C W Lee; M K Hong; J H Lee; H S Yang; J J Kim; S W Park; S J Park
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  87     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2001 Apr 
Date Detail:
Created Date:  2001-04-18     Completed Date:  2001-05-10     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:  951-4; A3     Citation Subset:  AIM; IM    
Department of Medicine, Asan Medical Center, University of Ulsan, Seoul, South Korea.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary*
Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
Aspirin / therapeutic use
Coronary Circulation
Follow-Up Studies
Middle Aged
Myocardial Infarction / etiology,  mortality,  therapy*
Risk Factors
Treatment Outcome
Reg. No./Substance:
0/Anti-Inflammatory Agents, Non-Steroidal; 50-78-2/Aspirin

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