Document Detail

Infarct size and myocardial salvage after primary angioplasty in patients presenting with symptoms for <12 h vs. 12-72 h.
MedLine Citation:
PMID:  19357105     Owner:  NLM     Status:  MEDLINE    
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.
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:
Type:  Journal Article     Date:  2009-04-08
Journal Detail:
Title:  European heart journal     Volume:  30     ISSN:  1522-9645     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-02     Completed Date:  2009-07-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  1322-30     Citation Subset:  IM    
Department of Cardiology, Aarhus University Hospital, Skejby, Brendstrupgaardsvej 100, Aarhus 8200, Denmark.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary / methods*
Coronary Angiography
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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