Prognostic value of clinical, echocardiographic and angiographic indicators in patients with large anterior ST-segment elevation myocardial infarction as a first acute coronary event

Autor: Marco Mirra, Rodolfo Citro, Paolo Chiodini, Pietro Giudice, Rosario Farina, Federico Piscione, Renato De Vecchis, Marco Di Maio, Francesco Vigorito, Michele Roberto Di Muro, Maria Vincenza Polito, Tiziana Attisano, Gennaro Galasso, Eduardo Bossone, Cesare Baldi
Přispěvatelé: Baldi, C, Polito, Mv, Citro, R, Farina, R, Attisano, T, Mirra, M, Chiodini, P, Di Muro, Mr, Di Maio, M, Vigorito, F, De Vecchis, R, Bossone, E, Piscione, F, Giudice, P, Galasso, G, Baldi, Cesare, Polito, Maria V., Citro, Rodolfo, Farina, Rosario, Attisano, Tiziana, Mirra, Marco, Chiodini, Paolo, Di Muro, Michele R., Di Maio, Marco, Vigorito, Francesco, De Vecchis, Renato, Bossone, Eduardo, Piscione, Federico, Giudice, Pietro, Galasso, Gennaro
Rok vydání: 2017
Předmět:
Male
medicine.medical_specialty
medicine.medical_treatment
large anterior ST-elevation segment myocardial infarction
030204 cardiovascular system & hematology
Anterior Descending Coronary Artery
Coronary Angiography
Electrocardiography
03 medical and health sciences
Percutaneous Coronary Intervention
0302 clinical medicine
Internal medicine
medicine
Humans
Hospital Mortality
Prospective Studies
030212 general & internal medicine
Myocardial infarction
Anterior Wall Myocardial Infarction
Aged
Aged
80 and over
Univariate analysis
Intra-Aortic Balloon Pumping
business.industry
Mortality rate
Percutaneous coronary intervention
General Medicine
Odds ratio
Middle Aged
primary percutaneous coronary intervention
medicine.disease
Survival Analysis
mortality
Treatment Outcome
Italy
Echocardiography
intra-aortic balloon pump
Heart failure
Multivariate Analysis
Conventional PCI
Cardiology
ST Elevation Myocardial Infarction
Female
Cardiology and Cardiovascular Medicine
business
prognosi
Zdroj: Journal of Cardiovascular Medicine. 18:946-953
ISSN: 1558-2027
DOI: 10.2459/jcm.0000000000000528
Popis: Background The risk of death in patients affected by ST-elevation segment myocardial infarction (STEMI) is well known, but more data are required to define the in-hospital mortality in special subsets. We sought to assess the prognostic value of indicators in patients with large anterior STEMI as a first acute coronary event, undergoing percutaneous coronary intervention (PCI) and intra-aortic balloon pump (IABP). Methods and results We evaluated 48 consecutive large anterior STEMI patients admitted as first acute coronary event, undergoing in acute phase both PCI and IABP. Patient demographics, clinical, noninvasive and invasive findings, together with in-hospital complications, were collected. Moreover, findings obtained after a 24-month follow-up were reported. The primary endpoint was in-hospital mortality, whereas the secondary endpoints were out of hospital mortality, rehospitalization for heart failure or reinfarction, and New York Heart Association (NYHA) class at least 2 at follow-up visit. The univariate analysis showed a significant association with symptom to balloon, left anterior descending coronary artery, myocardial blush grade, and wall motion score index. Results of the multivariable analysis revealed the strongest predictive power for in-hospital mortality of proximal left anterior descending coronary artery (odds ratio: 6.9; 95% confidence interval: 1.1-67.7) and of myocardial blush grade 0-1 (odds ratio: 5.5; 95% confidence interval: 1.0-38.8). In-hospital death occurred in 13 patients (27% of total cases), whereas, at follow-up, the mean of survival was 66.7 ± 7.0%. Conclusion The patients with large anterior STEMI as a first acute coronary event, undergoing PCI and IABP, had a very high in-hospital mortality, whereas the mortality rate over the follow-up period was lower. The involvement of a large territory at risk and the ineffective treatment in terms of myocardial reperfusion were the main predictors of in-hospital mortality.
Databáze: OpenAIRE
Externí odkaz: