Document Detail


Prognostic significance of early ischemia after acute myocardial infarction in low-risk patients. IRES (Ischemia Residua) Study Group.
MedLine Citation:
PMID:  8480638     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Early postinfarction angina is generally believed to imply an unfavorable prognosis. However, most of the published information devices from data collected in the prethrombolytic era, with widely differing populations and definitions of early angina, and very little data pertinent to low-risk patients are available. This collaborative study prospectively assessed the incidence of early recurrent ischemia after thrombolysis, as well as its prognostic significance, in 453 consecutive patients aged < or = 70 years with an uncomplicated course in the first 24 hours of a first myocardial infarction participating in the second Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI-2) trial. Early recurrent ischemia (spontaneous, transient ST depression or elevation of > 1 mm and/or T-wave inversion), assessed in the coronary care unit with continuous clinical and electrocardiographic monitoring, was documented in 35 of 453 patients (8%) and was unrelated to sex, age, electrocardiographic location, Q-wave or non-Q-wave infarction, thrombolytic agent and time to its administration. In-hospital cardiac events (7 deaths, 19 nonfatal reinfarctions and 8 urgent revascularizations) occurred in 15 of 35 patients (43%) with versus 19 of 418 without (4.5%) recurrent ischemia (p < 0.001). At the 6-month follow-up of 352 medically treated patients who did not have in-hospital events, the incidence of death, reinfarction and recurrent angina was comparable between patients with (2 of 18, 11%) and without (62 of 334, 19%) early ischemia (p = NS). With use of stepwise multivariate analysis, early ischemia was the only significant predictor of in-hospital cardiac events (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
P Silva; M Galli; L Campolo
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study    
Journal Detail:
Title:  The American journal of cardiology     Volume:  71     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1993 May 
Date Detail:
Created Date:  1993-05-24     Completed Date:  1993-05-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1142-7     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, Fondazione Clinica del Lavoro, Veruno, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angina Pectoris / epidemiology,  etiology*
Coronary Angiography
Death, Sudden, Cardiac / etiology
Electrocardiography
Female
Follow-Up Studies
Humans
Incidence
Life Tables
Male
Middle Aged
Myocardial Infarction / complications*,  drug therapy
Myocardial Revascularization
Prognosis
Prospective Studies
Recurrence
Risk Factors
Thrombolytic Therapy

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


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