Document Detail

In-hospital outcome of elderly patients with acute inferior myocardial infarction and right ventricular involvement.
MedLine Citation:
PMID:  9244209     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: There are some specific high-risk subgroups of patients with acute inferior myocardial infarction, such as older patients and those with right ventricular involvement. However, the clinical implications of right ventricular infarction in elderly subjects have not been studied previously. METHODS AND RESULTS: To determine the clinical impact of right ventricular involvement in elderly patients with inferior myocardial infarction, we studied the in-hospital outcome of 198 consecutive patients > or = 75 years of age with a first acute inferior myocardial infarction according to the presence of ECG or echocardiographic criteria of right ventricular infarction. In patients with right ventricular involvement (41%), in-hospital case fatality rate was 47% (mainly because of nonreversible low cardiac output cardiogenic shock) compared with 10% in patients without right ventricular involvement (P<.001). Patients with right ventricular involvement also had a significantly higher incidence of cardiogenic shock (32% versus 5%), which was independent of left ventricular ejection fraction, complete AV block (33% versus 9%), and interventricular septal rupture (9% versus 0%). After adjustment for age, sex, diabetes, shock on admission, left ventricular systolic dysfunction, and complete AV block, right ventricular infarction remained a powerful independent predictor of in-hospital death (adjusted odds ratio, 4.0; 95% confidence interval, 1.3 to 14.2). CONCLUSIONS: Elderly patients with acute inferior myocardial infarction have a substantially increased risk of death during hospitalization when right ventricular involvement is present. The poorer outcome is due mainly to the high incidence of cardiogenic shock and its infrequent reversibility.
H Bueno; R López-Palop; J Bermejo; J L López-Sendón; J L Delcán
Related Documents :
10750759 - Autopsy findings in early and late postoperative death after partial left ventriculectomy.
16878049 - Meningococcal purpura fulminans treated with medicinal leeches.
10670119 - Acute fatal vasoplegia and asystole induced by intravenous amiodarone after cardiopulmo...
18829609 - Possibilities and limitations of a miniaturized long-term extracorporeal life support s...
506939 - Hypovolemia and hypotension complicating management of acute cardiogenic pulmonary edema.
3421879 - A case of cardiovascular collapse due to adrenal insufficiency.
1457309 - Apparent elevation of serum ck-mb not due to acute myocardial infarction.
11603599 - Valve repair for rheumatic mitral disease.
10217469 - Congestive heart failure arising from diastolic dysfunction in the presence of normal l...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Circulation     Volume:  96     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1997 Jul 
Date Detail:
Created Date:  1997-08-26     Completed Date:  1997-08-26     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  436-41     Citation Subset:  AIM; IM    
Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Acute Disease
Age Factors
Aged, 80 and over
Heart Ventricles / pathology*,  physiopathology
Myocardial Infarction / pathology,  physiopathology*,  therapy
Shock, Cardiogenic / physiopathology

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

Previous Document:  Functional evaluation of lipid-lowering therapy by pravastatin in the Regression Growth Evaluation S...
Next Document:  Effects of ramipril on plasma fibrinolytic balance in patients with acute anterior myocardial infarc...