| Effect of delayed percutaneous transluminal coronary angioplasty of occluded coronary arteries after acute myocardial infarction. | |
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MedLine Citation:
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PMID: 8644638 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Whether angioplasty of occluded vessels after myocardial infarction may have beneficial effects on left ventricular function remains unknown. Patients with a first myocardial infarction and thrombolytic therapy who had an occluded infarct-related vessel at delayed coronary angiography were referred systematically for an elective coronary angioplasty performed between 3 and 4 weeks after the myocardial infarction. All patients underwent stress-redistribution-reinjection thallium-201 single-photon emission computed tomography for myocardial viability assessment. Prior angioplasty, a quantitative evaluation of global and regional left ventricular function, was performed. The study group consisted of 38 patients (aged 57 +/- 10 years); 18 had anterior wall infarctions and 20 inferior wall infarctions, but before angioplasty 3 had a patent artery and were excluded. Angioplasty was successful in 30 patients. At follow-up 13 patients (43%) had an occluded coronary artery. In contrast with patients with an occluded coronary artery at follow-up, those with a patent coronary artery had no left ventricular enlargement and had an improvement in both left ventricular ejection fraction (from 48 +/- 9% to 52 +/- 9.8%, p = 0.002) and regional wall motion index (delta = +0.95 SD, p <0.01). In patients with a patent vessel at follow-up, there was a positive correlation between the number of myocardial viable segments and improvement of the infarct zone wall motion (r = 0.52; p = 0.035), and the number of necrotic segments at baseline was positively correlated to the 4-month changes in end-diastolic volume indexes (r = 0.6; p = 0.04). Thus, elective revascularization of occluded coronary arteries with viable myocardium after myocardial infarction improves left ventricular function and lessens remodeling if the artery remains patent during follow-up. |
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Authors:
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J Garot; M Scherrer-Crosbie; J L Monin; P DuPouy; M L Bourachot; E Teiger; J Rosso; A Castaigne; P Gueret; J L Dubois-Randé |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The American journal of cardiology Volume: 77 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 1996 May |
Date Detail:
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Created Date: 1996-07-16 Completed Date: 1996-07-16 Revised Date: 2004-11-17 |
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: 915-21 Citation Subset: AIM; IM |
Affiliation:
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Féderation de Cardiologie, Créteil, France. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angioplasty, Transluminal, Percutaneous Coronary* Constriction, Pathologic Coronary Disease / complications, physiopathology, therapy* Female Humans Male Middle Aged Myocardial Infarction / complications*, physiopathology Prospective Studies Stroke Volume Time Factors Treatment Outcome Vascular Patency Ventricular Function, Left |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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