Document Detail


Diagnostic criteria and prognosis of perioperative myocardial infarction following coronary bypass.
MedLine Citation:
PMID:  6606085     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To evaluate the incidence of perioperative myocardial infarction (PMI), serial determinations of serum creatine kinase isoenzymes (CK-MB), electrocardiograms (ECGs), and pyrophosphate myocardial scans were performed in 112 patients undergoing isolated coronary bypass grafting. An abnormal increase in total CK-MB liberation (Q greater than 9.8 IU ml-1 kg) occurred in 25 patients (22.3%), new Q waves were present at ECG in 10 patients (8.9%), and the pyrophosphate myocardial scan was abnormal in 13 patients (11.6%). All tests were negative in 81 patients (72.3%). A diagnosis of PMI was established if confirmed by at least two of the techniques; this diagnosis was made in 15 patients (13.4%). The pattern of CK-MB liberation in patients with a PMI, characterized by a high peak and a prolonged release, was significantly different from that of patients without a PMI. The most important predictive factor for PMI was the duration of myocardial ischemia during the operation. Patients who had a PMI had more frequent early complications, and their prognosis at 2 years showed a 51% probability of remaining free of new cardiac events as compared to 96% for the group of patients without a PMI (p less than 0.001). PMI is not a benign complication of coronary bypass, and its detection appears improved by a combination of diagnostic tests.
Authors:
P Guiteras Val; L C Pelletier; M G Hernandez; J M Jais; B R Chaitman; G Dupras; B C Solymoss
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  86     ISSN:  0022-5223     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  1983 Dec 
Date Detail:
Created Date:  1984-01-27     Completed Date:  1984-01-27     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  878-86     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Clinical Enzyme Tests
Coronary Artery Bypass / adverse effects*
Creatine Kinase / blood
Electrocardiography
Female
Heart / radionuclide imaging
Humans
Intraoperative Complications
Isoenzymes
Male
Middle Aged
Mortality
Myocardial Infarction / diagnosis*,  etiology,  radionuclide imaging
Postoperative Complications
Prognosis
Chemical
Reg. No./Substance:
0/Isoenzymes; EC 2.7.3.2/Creatine Kinase

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


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