| Infarct size and myocardial salvage after primary angioplasty in patients presenting with symptoms for <12 h vs. 12-72 h. | |
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MedLine Citation:
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PMID: 19357105 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS: Primary angioplasty for ST-segment elevation myocardial infarction (STEMI) is recommended only if symptom duration is <12 h. We evaluated final infarct size (FIS) and myocardial salvage in early presenters (<12 h) vs. late presenters (12-72 h) undergoing primary angioplasty. METHODS AND RESULTS: Myocardial perfusion imaging (MPI) was performed acutely to assess area at risk (AAR) before angioplasty and repeated after 30 days to assess FIS (% of LV myocardium), salvage index (% non-infarcted AAR), and left ventricular ejection fraction (LVEF). Late presenters (n = 55) compared with early presenters (n = 341) had larger median FIS [14% (inter-quartile range 3-30) vs. 7% (2-18), P = 0.005], lower salvage index [53% (27-89) vs. 69% (45-91), P = 0.05], and lower LVEF [48% (44-58%) vs. 53% (47-59), P = 0.04]. However, FIS, salvage index, and LVEF correlated weakly with symptom duration (R(2)-values <0.10). In patients with TIMI-flow 0 (n = 247), late presenters had lower salvage index than early presenters [44% (23-73) vs. 57% (42-86), P = 0.03], but substantial salvage (>50% of AAR) was observed in 41% of late presenters despite total infarct-artery occlusion. CONCLUSION: FIS is larger in late presenters (>12 h) than early presenters after primary angioplasty for STEMI. However, substantial myocardial salvage can be obtained beyond the 12 h limit, even when the infarct-related artery is totally occluded. |
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Authors:
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Martin Busk; Anne Kaltoft; Søren S Nielsen; Morten Bøttcher; Michael Rehling; Leif Thuesen; Hans E Bøtker; Jens F Lassen; Evald H Christiansen; Lars R Krusell; Henning R Andersen; Torsten T Nielsen; Steen D Kristensen |
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Publication Detail:
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Type: Journal Article Date: 2009-04-08 |
Journal Detail:
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Title: European heart journal Volume: 30 ISSN: 1522-9645 ISO Abbreviation: Eur. Heart J. Publication Date: 2009 Jun |
Date Detail:
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Created Date: 2009-06-02 Completed Date: 2009-07-27 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8006263 Medline TA: Eur Heart J Country: England |
Other Details:
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Languages: eng Pagination: 1322-30 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Aarhus University Hospital, Skejby, Brendstrupgaardsvej 100, Aarhus 8200, Denmark. martin.busk@ki.au.dk |
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angioplasty, Transluminal, Percutaneous Coronary / methods* Coronary Angiography Female Humans Male Middle Aged Myocardial Infarction / pathology*, therapy* Myocardial Perfusion Imaging Practice Guidelines as Topic Severity of Illness Index Stroke Volume / physiology Time Factors Ventricular Function, Left / physiology |
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