Document Detail


Long-term clinical course of patients with isolated myocardial bridge.
MedLine Citation:
PMID:  20103971     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Myocardial bridge (MB) is regarded as a common benign lesion on coronary angiography (CAG). It is known to be harmless but may cause several cardiac events and recurrent hospitalization, so in the present study the long-term clinical course of patients with isolated MB and predictors of readmission were investigated.
METHODS AND RESULTS: Total 684 patients (343 males, 60.5+/-11.2 years) with persistent chest pain without critical stenosis on CAG were enrolled. The patients were divided into 2 groups according to the presence of MB. Clinical follow-up was performed with respect to readmission after baseline CAG. At a mean follow-up of 37 months, 92 patients (13.3%) were re-admitted because of 79 recurrent chest pain refractory to medication (11.5%), 8 myocardial infarctions (1.2%), 1 life-threatening arrhythmia (0.1%) and 4 deaths (0.6%). There was a significant higher incidence of readmission in the MB group (P=0.038). In multivariate analysis, long MB (hazard ratio (HR) 2.780; 95% confidence interval (CI) 1.070-7.218, P=0.036) and spontaneous vasospasm in CAG (HR 2.335; 95%CI 1.055-5.171, P=0.037) were the predictors of readmission. Moreover, additional use of aspirin or statin decreased the readmission rate.
CONCLUSIONS: This study suggests that MB on non-occlusive CAG is not benign and may cause recurrent chest pain, myocardial infarction or life-threatening arrhythmia. Especially, patients with a long MB and vasospasm on CAG need intensive medical therapy, including antiplatelet treatment.
Authors:
Sung-Soo Kim; Myung Ho Jeong; Hyun Kuk Kim; Min Chul Kim; Kyung Hun Cho; Min Goo Lee; Jum Suk Ko; Keun Ho Park; Doo Sun Sim; Nam Sik Yoon; Hyun Ju Yoon; Hyung Wook Park; Ju Han Kim; Young Joon Hong; Young Keun Ahn; Jeong Gwan Cho; Jong Chun Park; Jung Chaee Kang
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-01-26
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  74     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-26     Completed Date:  2010-05-24     Revised Date:  2011-02-18    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  538-43     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Angina Pectoris / epidemiology
Aspirin / therapeutic use
Coronary Angiography
Coronary Vasospasm / epidemiology*
Female
Follow-Up Studies
Hospitalization / statistics & numerical data
Humans
Male
Middle Aged
Multivariate Analysis
Myocardial Bridging / drug therapy,  epidemiology*,  radiography
Myocardial Infarction / epidemiology*
Patient Discharge
Patient Readmission / statistics & numerical data*
Platelet Aggregation Inhibitors / therapeutic use
Predictive Value of Tests
Proportional Hazards Models
Recurrence
Retrospective Studies
Risk Factors
Chemical
Reg. No./Substance:
0/Platelet Aggregation Inhibitors; 50-78-2/Aspirin

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


Previous Document:  Two-year clinical outcome after abciximab-coated stent implantation in patients with coronary artery...
Next Document:  Metabolic syndrome and carotid artery parameter in Koreans aged 50 years and older.