Document Detail


The impact of very late revascularization of occluded infarct-related artery on cardiac mortality and the incidence of sudden death in survivors of acute myocardial infarction - long-term observation.
MedLine Citation:
PMID:  12011779     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In survivors of acute myocardial infarction (AMI), an occluded infarct-related artery (IRA) is an important predictor of cardiac death (CD) and sudden death (SD). Early reperfusion of the IRA was associated with improved survival rate. The purpose of the present study was to assess if late IRA revascularization, performed 10-30 days after AMI, also has a beneficial effect on the incidence of CD and SD during an 18-month follow-up. MATERIAL/METHODS: The study population consisted of 93 post-MI patients with occluded IRA on coronary angiography. The patients were divided into 2 groups according to IRA status at discharge -- revascularized (47 patients) or occluded (46 patients) -- and followed. Before revascularization, the two groups of patients did not differ in the prevalence of clinical and angiographic variables, or in the incidence of risk factors for SD. In patients who underwent angioplasty or bypass graft surgery of closed IRA, the markers of electrical instability demonstrated no significant improvement after revascularization. RESULTS: During the 18-month follow-up a significantly lower incidence of CD (0% vs 15%, p<0.01) and SD (0% vs 11%, p<0.03) was observed in the group of patients with revascularized IRA than in the group of patients with occluded IRA. CONCLUSIONS: In survivors of AMI, late reperfusion of occluded IRA is associated with reduced 18-month cardiac mortality. The beneficial effect of this procedure on the incidence of sudden death, not associated with improvement in myocardial electrical stability, suggests that ischemia can be considered an important factor modulating the arrhythmogenic substrate.
Authors:
Jan Ruta; Halina Bolińska; Paweł Ptaszyński; Marcin Rosiak; Krzysztof Jerzy Wranicz; Maciej Kośmider; Ryszard Jaszewski; Janusz Zasłonka
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Medical science monitor : international medical journal of experimental and clinical research     Volume:  8     ISSN:  1234-1010     ISO Abbreviation:  Med. Sci. Monit.     Publication Date:  2002 May 
Date Detail:
Created Date:  2002-05-15     Completed Date:  2002-10-30     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9609063     Medline TA:  Med Sci Monit     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  CR364-70     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Institute of Cardiology, Medical University, Lodz, Poland. janruta@kki.net.pl
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angioplasty, Transluminal, Percutaneous Coronary*
Coronary Artery Bypass*
Death, Sudden
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Infarction / mortality*,  pathology*
Risk Factors
Time Factors
Treatment Outcome

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


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