Document Detail

Significance of left circumflex artery-related acute myocardial infarction without ST-T changes.
MedLine Citation:
PMID:  20159388     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Left circumflex (LC)-related acute myocardial infarction (AMI) presenting without ST-T changes has been underdiagnosed in the emergency department. There is little information on its clinical features and significance.
AIMS: The aims of the study were to investigate the clinical characteristics and outcomes of LC-related AMI without ST-T changes.
POPULATION AND METHODS: Ninety-six patients were admitted for LC-related AMI. Comparisons between those with and without ST-T changes were analyzed.
RESULTS: Twenty-two patients (23%) did not have ST-T changes, whereas 74 patients (77%) had them. Patients without ST-T changes had younger age (55.6 + or - 16.8 vs 62.6 + or - 12.0 years, P = .03), fewer presented as Killip III/IV (4.5% vs 27.4%, P = .02) and with lower creatine kinase (1647.3 + or - 1602.2 vs 2778.2 + or - 2343.3 IU/L, P = .037) and creatine kinase-MB (136.8 + or - 130.3 vs 247.7 + or - 200.0 IU/L, P = .017), and more were with concurrent culprit lesion in the middle or distal LC and right- or balanced-dominant coronary circulation (86.4% vs 44.6%, P < .001). During follow-up, the need for repeat percutaneous coronary intervention (48.6% vs 45.5%, P = .40) and recurrent infarction (13.5% vs 13.6%, P = .62) were similar between the 2 groups. The 30-day mortality (0% vs 5.4%, P = .35) and overall mortality rate (4.5% vs 12.2%, P = .28) between them were not different statistically.
CONCLUSION: The relatively lower prevalence of LC-related AMI without ST-T changes in the study might be underestimated. These patients have smaller infarct size than patients with ST-T changes without differences in the short- and long-term outcomes between them.
Su-Kiat Chua; Kou-Gi Shyu; Jun-Jack Cheng; Jer-Young Liou; Sheng-Chang Lin; Huei-Fong Hung; Shih-Huang Lee; Chiung-Zuan Chiu; Huey-Ming Lo
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The American journal of emergency medicine     Volume:  28     ISSN:  1532-8171     ISO Abbreviation:  Am J Emerg Med     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-17     Completed Date:  2010-03-19     Revised Date:  2011-03-22    
Medline Journal Info:
Nlm Unique ID:  8309942     Medline TA:  Am J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  183-8     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Section of Cardiology, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 111, Taiwan.
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MeSH Terms
Aged, 80 and over
Coronary Angiography
Diagnostic Errors / prevention & control*
Logistic Models
Middle Aged
Multivariate Analysis
Myocardial Infarction / diagnosis*,  physiopathology
Retrospective Studies
Treatment Outcome
Comment In:
Am J Emerg Med. 2011 Mar;29(3):348-9   [PMID:  21159463 ]

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