| Primary angioplasty of unprotected left main coronary artery for acute anterolateral myocardial infarction. | |
| | |
MedLine Citation:
|
PMID: 15550729 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Mortality of acute unprotected left main coronary artery (LMCA) occlusion is very high. The objectives of this analysis were to determine the effect of primary angioplasty and the impact of cardiogenic shock on unprotected LMCA occlusion-induced acute anterolateral myocardial infarction (AAMI). METHODS: Of 1,736 consecutive patients with acute myocardial infarction (AMI), 38 (2.2%) had LMCA occlusion-induced AAMI with Thrombolysis in Myocardial Infarction (TIMI) flow less than or equal to 2. All were given primary angioplasty. RESULTS: Of these 38 patients, 17 (45%) were discharged, and 21 (55%) died in-hospital. Cardiogenic shock was overt in 28 patients; 47.1% of the survival group and 95.2% of the mortality group (p=0.0008). On arrival, the survival-group had higher pH (7.40+/-0.10 vs. 7.30+/-0.14; p=0.013) and base excess (-4.5+/-3.9 vs. -10.4+/-6.0 mEq/L; p=0.0013). In the survival group reperfusion was successful in 100% of patients, as opposed to 57.1% in the mortality group (p=0.0020), and the incident of stenting was not different between the two groups (64.7% vs. 71.4%, p=0.66). Shock patients had lower successful angioplasty rate (67.9% vs. 100%, p=0.040), higher in-hospital mortality (71.4% vs. 10.0%, p=0.0008), and higher 1-year mortality rates (p=0.0064), than stable patients. All shock patients with failed angioplasty died, but the mortality rate was 57.9% (p=0.021) when angioplasty was successful. CONCLUSIONS: Patients presenting with AAMI, LMCA occlusion, and cardiogenic shock have poor survival regardless of primary angioplasty in conjunction with coronary stents. Nevertheless, primary angioplasty is a feasible and effective procedure, and it may save lives in this clinical setting. |
| | |
Authors:
|
Koyu Sakai; Yoshihisa Nakagawa; Takeshi Kimura; Kenji Ando; Hiroyoshi Yokoi; Masashi Iwabuchi; Katsumi Inoue; Hideyuki Nosaka; Masakiyo Nobuyoshi |
Related Documents
:
|
8322689 - Coronary atherectomy versus angioplasty: the cava study. 9243139 - Changing characteristics and in-hospital outcome in patients admitted with acute myocar... 10327779 - Primary angioplasty for cardiogenic shock complicating acute myocardial infarction. 9438169 - A late retroperitoneal hematoma mimicking acute appendicitis--an unusual complication o... 2528079 - Transluminal angioplasty of intracerebral vessels for cerebral arterial spasm: reversal... 2958279 - Repeat balloon coronary angioplasty for symptomatic restenosis: a note of caution. 1297689 - Validation of an adaptive software trigger and arrhythmia diagnostic algorithm. 15165939 - Blood pressure dynamics during simulated ventricular tachycardia in patients after righ... 17030749 - Cerebellar infarction presenting isolated vertigo: frequency and vascular topographical... |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: The Journal of invasive cardiology Volume: 16 ISSN: 1042-3931 ISO Abbreviation: J Invasive Cardiol Publication Date: 2004 Nov |
Date Detail:
|
Created Date: 2004-11-19 Completed Date: 2005-01-24 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8917477 Medline TA: J Invasive Cardiol Country: United States |
Other Details:
|
Languages: eng Pagination: 621-5 Citation Subset: IM |
Affiliation:
|
Masakiyo Nobuyoshi, MD, Kokura Memorial Hospital, 1-1 Kifune-machi, Kokurakita-ku, Japan, 802-8555. kmhptca@nn.iij4u.or.jp. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Age Factors Aged Aged, 80 and over Angioplasty, Transluminal, Percutaneous Coronary / methods, mortality* Case-Control Studies Cause of Death* Coronary Angiography / methods Coronary Circulation Coronary Stenosis / complications*, radiography Coronary Vessels / physiopathology Female Follow-Up Studies Humans Male Middle Aged Myocardial Infarction / etiology, mortality*, radiography, therapy* Probability Reference Values Retrospective Studies Risk Assessment Severity of Illness Index Sex Factors Shock, Cardiogenic / diagnosis, mortality, therapy Survival Analysis Treatment Outcome |
| Comments/Corrections | |
Comment In:
|
J Invasive Cardiol. 2004 Nov;16(11):626
[PMID:
15550730
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Coronary pressure notch: an early non-hyperemic visual indicator of the physiologic significance of ...
Next Document: Predictors of survival after contemporary percutaneous coronary revascularization for acute myocardi...