Document Detail

Survival benefit after revascularization is independent of left ventricular ejection fraction improvement in patients with previous myocardial infarction and viable myocardium.
MedLine Citation:
PMID:  15821962     Owner:  NLM     Status:  MEDLINE    
PURPOSE: This study was designed to assess the relationships among myocardial viability, changes in left ventricular (LV) ejection fraction after coronary revascularization and long-term event-free survival in patients with previous myocardial infarction and LV dysfunction. METHODS: We studied 253 patients with previous myocardial infarction and evidence of dysfunctional viable myocardium as assessed by echocardiography and 99mTc-sestamibi imaging. Coronary revascularization was performed in 142 patients, while 111 were medically treated. In revascularized patients, echocardiography was repeated 12 months later to detect LV ejection fraction improvement, defined as an increase of > or =5% compared with baseline. All patients were followed for a mean period of 52+/-29 months. Cardiac death and non-fatal myocardial infarction were considered as events. RESULTS: Event-free survival was higher in revascularized than in medically treated patients (P<0.001). Ejection fraction increased by > or =5% in 82 (58%) revascularized patients, and the extent of viable myocardium was the strongest predictor of such improvement (P<0.001). Event-free survival was similar for patients with (n=82) and patients without (n=60) LV ejection fraction improvement after revascularization, and it was better in revascularized than in medically treated patients in the presence of either substantial (> or =5 viable segments) or low-intermediate (1-4 viable segments) viability (both P<0.01). CONCLUSION: In patients with previous myocardial infarction and evidence of viable myocardium, coronary revascularization procedures improve outcome at long-term follow-up independently of LV ejection fraction improvement.
Wanda Acampa; Mario Petretta; Letizia Spinelli; Marco Salvatore; Alberto Cuocolo
Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article     Date:  2004-11-20
Journal Detail:
Title:  European journal of nuclear medicine and molecular imaging     Volume:  32     ISSN:  1619-7070     ISO Abbreviation:  Eur. J. Nucl. Med. Mol. Imaging     Publication Date:  2005 Apr 
Date Detail:
Created Date:  2005-04-11     Completed Date:  2005-08-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101140988     Medline TA:  Eur J Nucl Med Mol Imaging     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  430-7     Citation Subset:  IM    
Department of Biomorphological and Functional Sciences, Institute of Biostructure and Bioimages, National Council of Research, University Federico II, Naples, Italy.
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MeSH Terms
Disease-Free Survival
Italy / epidemiology
Middle Aged
Myocardial Ischemia / diagnosis,  epidemiology*,  surgery*
Myocardial Revascularization / statistics & numerical data*
Risk Assessment / methods*
Risk Factors
Stroke Volume*
Survival Analysis
Survival Rate
Treatment Outcome
Ventricular Dysfunction, Left / diagnosis,  epidemiology*,  surgery*

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