Document Detail


Prognostic value of minimal blood flow restoration in patients with acute myocardial infarction after reperfusion therapy.
MedLine Citation:
PMID:  19763661     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The prognostic impact of low-flow reperfusion after percutaneous coronary intervention (PCI) in patients with ST-segment elevation acute myocardial infarction (STEMI) is unknown. The aim of the study was to investigate the impact of low-flow reperfusion after PCI in patients with STEMI. METHODS: This study included 1,761 patients with STEMI with a baseline thrombolysis in myocardial infarction (TIMI) flow grade 0 and no collateral circulation to the infarcted region before primary PCI. The primary outcome was 1-year mortality. RESULTS: At the end of PCI procedure there were 115 patients with post-PCI TIMI flow grade 0; 57 patients with TIMI flow grade 1; 218 patients with TIMI flow grade 2; and 1,371 patients with TIMI flow grade 3. At 1 year there were 36 deaths in patients with TIMI grade 0; 28 deaths in patients with TIMI grade 1; 42 deaths in patients with TIMI grade 2; and 162 deaths in patients with TIMI grade 3 [estimates of mortality 32.6, 49.1, 19.6 and 12.1%, respectively; odds ratio (OR) = 1.76, 95% CI 1.08-2.86, P = 0.02, for TIMI flow grade 1 vs. TIMI flow grade 0]. The Cox proportional hazards model identified post-PCI TIMI flow grade as an independent predictor of 1-year mortality [hazard ratio (HR) = 1.99, 95% CI 1.17-3.28; P = 0.01 for TIMI flow grade 1 vs. TIMI flow grade 0]. CONCLUSIONS: Patients with STEMI with totally occluded infarct-related arteries and no collateral blood flow to the infarcted region show a greater mortality with post-PCI TIMI flow grade 1 than TIMI flow grade 0.
Authors:
Gjin Ndrepepa; Dritan Keta; Stefanie Schulz; Robert A Byrne; Julinda Mehilli; J?rgen Pache; Melchior Seyfarth; Albert Sch?mig; Adnan Kastrati
Publication Detail:
Type:  Controlled Clinical Trial; Journal Article     Date:  2009-09-10
Journal Detail:
Title:  Clinical research in cardiology : official journal of the German Cardiac Society     Volume:  99     ISSN:  1861-0692     ISO Abbreviation:  Clin Res Cardiol     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-01-22     Completed Date:  2010-04-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101264123     Medline TA:  Clin Res Cardiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  13-9     Citation Subset:  IM    
Affiliation:
Deutsches Herzzentrum, Technische Universit?t, Lazarettstr. 36, 80636, Munich, Germany. ndrepepa@dhm.mhn.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary / methods*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Infarction / mortality,  physiopathology,  therapy*
Myocardial Reperfusion / mortality*
Predictive Value of Tests
Prognosis
Proportional Hazards Models
Thrombolytic Therapy / methods

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


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