Document Detail


Predictors and short-term prognosis of angiographically detected distal embolization after emergency percutaneous coronary intervention for ST-elevation acute myocardial infarction.
MedLine Citation:
PMID:  19730924     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Distal embolization after percutaneous coronary intervention (PCI) is one of the major mechanisms of no-reflow. The aim of the study was to investigate clinical, angiographic predictors of distal embolization on angiography in patients with ST-elevation acute myocardial infarction (AMI) after PCI, and to assess the short-term prognosis of patients with distal embolization. METHODS: There were 318 consecutive AMI patients, who underwent primary PCI within 12 h of symptom onset, and were divided into distal embolization group (N = 97) and non-distal embolization group (N = 221), based on cineangiograms performed during PCI. RESULTS: Distal embolization was present in 97 patients (30.5%), and more often observed in female sex (29.9 vs. 16.3%, P = 0.006), in patient with right coronary artery of infarct-related artery (IRA) (44.3 vs. 28.1%, P = 0.017), pre-revascularization thrombolysis in myocardial infarction (TIMI) flow <or= 2 (88.7 vs. 79.2%, P = 0.004), high thrombus burden (72.2 vs. 32.1%, P < 0.001). Based on logistic regression analysis, high thrombus burden on angiography (OR 5.018, 95% CI 2.843-8.857, P < 0.001) and female sex (OR 3.020, 95% CI 1.574-5.794, P = 0.001) and right coronary artery of IRA (OR 2.218, 95% CI 1.172-4.199, P = 0.014) were independent predictors of distal embolization. Patients in distal embolization group had an increased risk of short-term major adverse events (12.4 vs. 4.5%, P = 0.011) when compared with patients in non-distal embolization group. CONCLUSIONS: High thrombus burden on angiography before PCI and right coronary artery of IRA and female sex are the significant predictors of distal embolization in patients with AMI after PCI. In addition, distal embolization on angiography predicts an adverse short-term outcome in AMI patients.
Authors:
Li Dong-bao; Hua Qi; Liu Zhi; Wang Shan; Jin Wei-ying
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical research in cardiology : official journal of the German Cardiac Society     Volume:  98     ISSN:  1861-0692     ISO Abbreviation:  Clin Res Cardiol     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2010-01-22     Completed Date:  2010-03-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101264123     Medline TA:  Clin Res Cardiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  773-9     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Xuanwu Hospital, Capital Medical University, Changchun Ave 45, 100053 Beijing, Xuanwu District, China. leetobo@sina.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects*,  methods
Coronary Angiography*
Embolism / diagnosis,  etiology*
Emergency Medical Services
Female
Follow-Up Studies
Humans
Logistic Models
Male
Middle Aged
Myocardial Infarction / physiopathology,  therapy*
Prognosis
Retrospective Studies
Risk Factors
Sex Factors
Young Adult

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