| Impact of cardiac and renal dysfunction on inhospital morbidity and mortality of patients with acute myocardial infarction undergoing primary angioplasty. | |
| | |
MedLine Citation:
|
PMID: 17452149 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Risk stratification of patients with ST-elevation myocardial infarction (STEMI) undergoing primary angioplasty is important in order to predict outcomes and to delineate targeted therapeutic strategies. Although the prognostic implications of reduced left ventricular ejection fraction (LVEF) and creatinine clearance (CrCl) have been recognized, the clinical and prognostic impact of their combination has never been prospectively evaluated. METHODS: We stratified 467 patients with STEMI undergoing primary angioplasty according to LVEF and CrCl values at admission: CrCl > 60 mL/min and LVEF > 40% (group 1, n = 261); CrCl < or = 60 mL/min and LVEF > 40% (group 2, n = 113); CrCl > 60 mL/min and LVEF < or = 40% (group 3, n = 60); CrCl < or = 60 mL/min and LVEF < or = 40% (group 4, n = 33). RESULTS: Inhospital mortality was different in the 4 groups (1% in group 1, 3% in group 2, 15% in group 3, 30% in group 4) (P < .001). The incidence of combined end point of death, acute pulmonary edema, cardiogenic shock, and acute renal failure requiring mechanical support increased progressively from group 1 to group 4 (5%, 17%, 33%, and 48%, respectively) (P < .001). We found a significant gradient of risk in terms of inhospital mortality and combined end point when patients outcome was evaluated according to the presence of both normal LVEF and CrCl (group 1), impairment in only 1 of these 2 parameters (group 2 and 3 pooled together), and combined LVEF and CrCl reductions (group 4). CONCLUSIONS: Reduced LVEF and CrCl are strong independent predictors of increased inhospital morbidity and mortality, and their combined evaluation provides a simple tool for early risk stratification in patients with STEMI treated with primary angioplasty. |
| | |
Authors:
|
Giancarlo Marenzi; Marco Moltrasio; Emilio Assanelli; Gianfranco Lauri; Ivana Marana; Marco Grazi; Mara Rubino; Monica De Metrio; Fabrizio Veglia; Antonio L Bartorelli |
Related Documents
:
|
10588209 - A randomized trial comparing primary angioplasty with a strategy of short-acting thromb... 10174309 - Treating myocardial infarction in the post-gusto era. a european perspective. 11108329 - Acute success rates of percutaneous transluminal coronary angioplasty in the treatment ... 10976149 - Treatment of true bifurcation stenosis by elective stent implantation in parent vessel ... 7892819 - Coronary anatomic and procedural characteristics of patients randomized to coronary ang... 17709919 - Outcomes of primary percutaneous coronary intervention in acute myocardial infarction a... 20846639 - Early and late cardiac ventricular reverse remodeling after catheter ablation for lone ... 6684389 - Protection of turkeys against furazolidone-induced cardiomyopathy. 12406359 - Black-white differences in severity of coronary artery disease among individuals with a... |
Publication Detail:
|
Type: Comparative Study; Journal Article |
Journal Detail:
|
Title: American heart journal Volume: 153 ISSN: 1097-6744 ISO Abbreviation: Am. Heart J. Publication Date: 2007 May |
Date Detail:
|
Created Date: 2007-04-24 Completed Date: 2007-05-22 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: United States |
Other Details:
|
Languages: eng Pagination: 755-62 Citation Subset: AIM; IM |
Affiliation:
|
Centro Cardiologico Monzino, I.R.C.C.S, Institute of Cardiology, University of Milan, Milan, Italy. giancarlo.marenzi@ccfm.it |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Angioplasty, Transluminal, Percutaneous Coronary* Causality Comorbidity Female Hospital Mortality Humans Incidence Italy / epidemiology Kidney Failure, Acute / epidemiology Logistic Models Male Middle Aged Multivariate Analysis Myocardial Infarction / diagnosis, epidemiology*, therapy* Odds Ratio Prognosis Prospective Studies Pulmonary Edema / epidemiology Renal Insufficiency / epidemiology* Risk Assessment / methods Shock, Cardiogenic / epidemiology Ventricular Dysfunction, Left / epidemiology* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Meta-analysis of clinical trials on use of drug-eluting stents for treatment of acute myocardial inf...
Next Document: Reduction of neointimal hyperplasia after coronary stenting by pioglitazone in nondiabetic patients ...