1-Year Outcomes of Delayed Versus Immediate Intervention in Patients With Transient ST-Segment Elevation Myocardial Infarction

Autor: Arno P. van der Weerdt, Elvin Kedhi, Jorrit S. Lemkes, Maarten A.H. van Leeuwen, Albert C. van Rossum, Paul Knaapen, Martijn Meuwissen, Peter M. van de Ven, Stijn L. Brinckman, Koen M. Marques, Yolande Appelman, Colette E. Saraber, Gladys N. Janssens, Henk Everaars, Niels van Royen, Robin Nijveldt, Renicus S Hermanides, Niels J.W. Verouden, Koos Plomp, Cornelis P Allaart, Nina W. van der Hoeven, Jeroen Schaap, Alexander Nap, Jorik R. Timmer
Přispěvatelé: Cardiology, APH - Methodology, ACS - Heart failure & arrhythmias, Epidemiology and Data Science, ACS - Atherosclerosis & ischemic syndromes, ACS - Microcirculation
Rok vydání: 2019
Předmět:
Male
medicine.medical_specialty
Time Factors
medicine.medical_treatment
Vascular damage Radboud Institute for Health Sciences [Radboudumc 16]
Infarction
030204 cardiovascular system & hematology
Revascularization
Ventricular Function
Left
Time-to-Treatment
03 medical and health sciences
Percutaneous Coronary Intervention
0302 clinical medicine
Recurrence
Risk Factors
Interquartile range
Cardiac magnetic resonance imaging
Internal medicine
Multicenter trial
Humans
Medicine
ST segment
Prospective Studies
cardiovascular diseases
030212 general & internal medicine
Myocardial infarction
Acute Coronary Syndrome
Aged
Netherlands
Ejection fraction
medicine.diagnostic_test
business.industry
Vascular damage Radboud Institute for Molecular Life Sciences [Radboudumc 16]
Stroke Volume
Middle Aged
medicine.disease
Magnetic Resonance Imaging
Treatment Outcome
Cardiology
ST Elevation Myocardial Infarction
Female
Cardiology and Cardiovascular Medicine
business
Zdroj: Janssens, GN, van der Hoeven, NW, Lemkes, JS, Everaars, H, van de Ven, PM, Marques, KMJ, Nap, A, van Leeuwen, M A H, Appelman, JEA, Knaapen, P, Verouden, CJW, Allaart, CP, Brinckman, S, Saraber, CE, Plomp, K, Timmer, J R, Kedhi, E, Hermanides, R S, Meuwissen, M, Schaap, J, Van Der Weerdt, A P, van Rossum, AC, Nijveldt, R & van Royen, N 2019, ' 1-Year Outcomes of Delayed Versus Immediate Intervention in Patients With Transient ST-Segment Elevation Myocardial Infarction ', JACC Cardiovascular Interventions, vol. 12, no. 22, pp. 2272-2282 . https://doi.org/10.1016/j.jcin.2019.07.018
JACC Cardiovascular Interventions, 12(22), 2272-2282. Elsevier Inc.
JACC. Cardiovascular Interventions, 12, 22, pp. 2272-2282
JACC. Cardiovascular Interventions, 12, 2272-2282
ISSN: 1936-8798
DOI: 10.1016/j.jcin.2019.07.018
Popis: Item does not contain fulltext OBJECTIVES: The aim of the present study was to determine the effect of a delayed versus an immediate invasive approach on final infarct size and clinical outcome up to 1 year. BACKGROUND: Up to 24% of patients with acute coronary syndromes present with ST-segment elevation myocardial infarction (STEMI) but show complete resolution of ST-segment elevation and symptoms before revascularization. Current guidelines do not clearly state whether these patients with transient STEMI should be treated with a STEMI-like or non-ST-segment elevation acute coronary syndrome-like intervention strategy. METHODS: In this multicenter trial, 142 patients with transient STEMI were randomized 1:1 to either delayed or immediate coronary intervention. Cardiac magnetic resonance imaging was performed at 4 days and at 4-month follow-up to assess infarct size and myocardial function. Clinical follow-up was performed at 4 and 12 months. RESULTS: In the delayed (22.7 h) and the immediate (0.4 h) invasive groups, final infarct size as a percentage of the left ventricle was very small (0.4% [interquartile range: 0.0% to 2.5%] vs. 0.4% [interquartile range: 0.0% to 3.5%]; p = 0.79), and left ventricular function was good (mean ejection fraction 59.3 +/- 6.5% vs. 59.9 +/- 5.4%; p = 0.63). In addition, the overall occurrence of major adverse cardiac events, consisting of death, recurrent infarction, and target lesion revascularization, up to 1 year was low and not different between both groups (5.7% vs. 4.4%, respectively; p = 1.00). CONCLUSIONS: At follow-up, patients with transient STEMI have limited infarction and well-preserved myocardial function in general, and delayed or immediate revascularization has no effect on functional outcome and clinical events up to 1 year.
Databáze: OpenAIRE
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