Document Detail

Reperfusion arrhythmias during coronary angioplasty for acute myocardial infarction predict ST-segment resolution.
MedLine Citation:
PMID:  12966264     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Despite early recanalization of an occluded infarct-related artery, myocardial reperfusion may remain impaired due to microvascular injury. Reperfusion arrhythmias may indicate successful microvascular reperfusion. METHODS: Microvascular reperfusion was assessed prospectively in 42 consecutive patients with ST-segment elevation acute myocardial infarction (AMI) by evaluation of the resolution of ST-segment elevation (<50% of initial level) immediately after successful coronary angioplasty. Patients were divided into two groups: those with ST resolution (n=24) and those without ST resolution (n=18). The presence of reperfusion arrhythmias immediately after recanalization was recorded. RESULTS: Patients with ST resolution were younger (54+/-12 years compared with 64+/-17 years, P=0.04), their pain-to-recanalization time was shorter (195+/-87 min compared with 294+/-179 min, P=0.05), they were less often diabetic (13% compared with 24%, P=0.05) and were more often given IIb/IIIa inhibitors (58% compared with 22%, P=0.02). Reperfusion arrhythmias were observed in 15 out of 24 patients with ST resolution (62%) but in only one out of 18 without ST resolution (5%) (P<0.01). Reperfusion arrhythmias included accelerated idioventricular rhythm, 13 (81%); multifocal ventricular premature beats, two (13%); and ventricular tachycardia, one (6%). The sensitivity and specificity of reperfusion arrhythmias for ST resolution were 62 and 95%, respectively. In a logistic regression model including age, time to treatment, diabetes, use of IIb/IIIa inhibitors and reperfusion arrhythmias, only the latter was found to be an independent predictor of ST resolution (P<0.01). CONCLUSION: Reperfusion arrhythmias following coronary angioplasty for AMI are a highly specific marker for ST resolution and may indicate successful microvascular reperfusion.
Reuben Ilia; Guy Amit; Carlos Cafri; Harel Gilutz; Akram Abu-Ful; Jean Marc Weinstein; Sergey Yaroslavtsev; Moche Gueron; Doron Zahger
Related Documents :
12764694 - Wavelet transform analysis of heart rate variability to assess the autonomic changes as...
4685084 - Reduction of experimental myocardial infarct size by corticosteroid administration.
17365974 - The electrocardiographic reperfusion peak in patients with st-elevation myocardial infa...
19471924 - Interrelation of st-segment depression during bicycle ergometry and extent of myocardia...
12104074 - Spontaneous rectus muscle hematoma following streptokinase therapy for acute myocardial...
11988954 - Passive constraint and new shape-change devices for heart failure.
Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  Coronary artery disease     Volume:  14     ISSN:  0954-6928     ISO Abbreviation:  Coron. Artery Dis.     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-09-10     Completed Date:  2004-03-19     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9011445     Medline TA:  Coron Artery Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  439-41     Citation Subset:  IM    
Department of Cardiology, Soroka Medical Center, Ben-Gurion University of the Negev, PO Box 151, Beer Sheva 84101, Israel.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary*
Arrhythmias, Cardiac / diagnosis*,  mortality,  therapy*
Hospital Mortality
Intraoperative Complications / etiology*,  mortality,  therapy*
Middle Aged
Myocardial Infarction / diagnosis*,  mortality,  therapy*
Myocardial Reperfusion Injury / diagnosis*,  mortality,  therapy*
Platelet Glycoprotein GPIIb-IIIa Complex / therapeutic use
Postoperative Complications / drug therapy,  etiology,  mortality
Predictive Value of Tests
Prospective Studies
Sensitivity and Specificity
Treatment Outcome
Reg. No./Substance:
0/Platelet Glycoprotein GPIIb-IIIa Complex

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

Previous Document:  Serum tumour necrosis factor-alpha, interleukin-2 and interleukin-10 activation in stable angina and...
Next Document:  Advancing age is associated with diminished vascular remodeling and impaired vasodilation in resista...