| Hospital outcome of moderate to severe pericardial effusion complicating ST-elevation acute myocardial infarction. | |
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MedLine Citation:
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PMID: 20975001 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Hospital prognosis of moderate to severe pericardial effusion (MPE; ≥10 mm) in ST-elevation myocardial infarction is largely unknown. METHODS AND RESULTS: Data from 446 ST-elevation myocardial infarction patients, 228 with MPE-88 with cardiac tamponade (CT) and electromechanical dissociation (EMD), 44 with CT without EMD (w/oEMD), and 96 without initial CT-and 218 with small PE (5 to 9 mm), were compared. Patients with MPE without initial CT were also compared with 96 patients without PE. CT patients showed larger PE (P<0.001) than those without initial CT; 85% of those with CT+EMD and 86% with CTw/oEMD were treated with pericardiocentesis and 10% and 21% were treated with a surgical repair, respectively. Among MPE patients, 30-day mortality was 43% and was higher in those with CT+EMD (operated, 89%; and nonoperated, 85%) than in those with CTw/oEMD (22% and 11%, respectively; P<0.001) and those without initial CT (17%; P<0.001). It was also higher than in patients with small PE (10%; P<0.001) or those without PE (6%; P=0.001). Death was attributable to cardiac rupture in 83% of patients with CT+EMD, 7% with CTw/oEMD, and 8% with MPE without initial CT and occurred late (≥7 days) in 14%, 67%, and 100%, respectively. CONCLUSIONS: MPE carries an increased mortality that is highest in patients with CT+EMD. In those with CTw/oEMD, however, mortality is considerably low after pericardiocentesis, and subsequent management may be individualized because a conservative approach is often successful. Importantly, MPE patients without initial CT are not free from late rupture and deserve further investigation. |
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Authors:
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Jaume Figueras; José A Barrabés; Vicens Serra; Josefa Cortadellas; Rosa-Maria Lidón; Alvaro Carrizo; David Garcia-Dorado |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-10-25 |
Journal Detail:
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Title: Circulation Volume: 122 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-11-09 Completed Date: 2010-12-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 1902-9 Citation Subset: AIM; IM |
Affiliation:
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Unitat Coronària, Servei de Cardiologia, Hospital Universitari Vall d'Hebron, Barcelona, Spain. 5751jfb@comb.es |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Atrial Fibrillation / epidemiology Cardiac Tamponade / complications*, mortality, therapy Female Heart Injuries / epidemiology Heart Rupture, Post-Infarction / epidemiology Hematocrit Hospital Mortality Humans Male Middle Aged Myocardial Infarction / complications*, mortality, surgery, therapy Pericardial Effusion / etiology*, therapy Pericarditis / epidemiology Prognosis Survival Rate Treatment Outcome |
| Comments/Corrections | |
Comment In:
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Circulation. 2010 Nov 9;122(19):1898-9
[PMID:
20974994
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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