| Autor: |
Sicari, Rosa, Pingitore, Alessandro, Minardi, Giovanni, Gandolfo, Nicola, Seveso, Giovanni, Chiarella, Francesco, Bolognese, Leonardo, Chiarandà, Giacomo, Petix, Nunzia, Sciavo, Maria Grazia, Previtali, Mario, Margaria, Franca, Magaia, Omelia, Bianchi, Federico, Pirelli, Salvatore, de Moura Duarte, Luis Felipe, de Sousa, Maria José, Severi, Silva, Raciti, Mauro, Landi, Patrizia, Picano, Eugenio |
| Zdroj: |
Journal of the American College of Cardiology; February 1995, Vol. 25 Issue: 2, Number 2 Supplement 1 p402A-402A, 1p |
| Abstrakt: |
The identification of future reinfarction seems an elusive target for physiologic testing, consistently with the accepted notion that it is plaque type, rather than plaque size, that matters in provoking coronary occlusion. However, large sample populations are needed to detect phenomena with a low event rate. In addition, one should employ noninvasive stress test results that are tightly related to the extent and severity of CAD — in a stronger way than exercise-ECG. Aim of this study was to assess the capability of dipyridamole echocardiography test (DET) to predict reinfarction in patients evaluated early after acute uncomplicated myocardial infarction. In an updated analysis of the EPIC Study, we assessed the value of DET in predicting reinfarction in 1080 pts (age =56±9, 926 men and 154 women) evaluated early (10±5 days) after uncomplicated acute myocardial infarction and followed up for 14±10 months. A positive test occurred in 475 pts (44%). During follow-up, there were 50 reinfarctions: 45 non-fatal, and 5 fatallfollowed by cardiac death after≤4 days from the reinfarction). Reinfarction (either nonfatal or fatal) occurred in 30 pts with positive and in 20 with negative DET (6.3 vs 3.3%, p<0.01). Nonfatal reinfarction occurred in 25 patients with positive and in 20 with negative DET (5 vs 3%, P=0.05). Reinfarction was fatal in 5 out of 25 reinfarcted patients with positive and in none out of 20 reinfarcted patients with negative DET (20 vs 0%, P=0.07). The relative risk (i.e., the relative risk of the occurrence of future cardiac events in the group with negative DET) of reinfarction was 1.9. In conclusion, DET positivity identifies patients evaluated early after uncomplicated myocardial infarction at higher risk of reinfarction and especially of fatal reinfarction. |
| Databáze: |
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