Factors that predict improvement in left ventricular ejection fraction after coronary angioplasty for acute myocardial infarction
| Autor: | Paula F. Miller, Jeffrey D. Katz, Richard A. Weintraub, E. Joseph LeBauer, Thomas Stuckey, Charles Hansen, Bruce R. Brodie |
|---|---|
| Rok vydání: | 1987 |
| Předmět: |
Male
medicine.medical_specialty Cardiac output medicine.medical_treatment Myocardial Infarction Hemodynamics Collateral Circulation Coronary Angiography Internal medicine Angioplasty medicine Humans Streptokinase Myocardial infarction Cardiac Output Univariate analysis Ejection fraction business.industry Middle Aged medicine.disease Collateral circulation Prognosis Combined Modality Therapy Myocardial Contraction Urokinase-Type Plasminogen Activator Stenosis Cardiology Female Cardiology and Cardiovascular Medicine business Angioplasty Balloon |
| Zdroj: | Catheterization and cardiovascular diagnosis. 13(6) |
| ISSN: | 0098-6569 |
| Popis: | Acute and follow-up angiograms were analyzed in 75 patients with acute myocardial infarction treated with emergency coronary angioplasty to determine factors that might predict improvement in left ventricular ejection fraction. Ejection fraction improved 8.4 +/- 8.2% in 60 patients who maintained patent infarct vessels at follow-up angiography, compared with -4.1 +/- 6.0% in 15 patients who developed reocclusion (p less than .001). In patients with patent infarct vessels, univariate analysis revealed the following significant predictors of improvement in ejection fraction: initial ejection fraction (r = -.38, p less than .003) subtotal vs total stenosis (12.9 +/- 9.3% vs 6.9 +/- 7.3%, p less than .02), infarct vessel (left anterior descending 11.0 +/- 8.4%, right 6.8 +/- 6.4%, circumflex 2.6 +/- 7.5%, p less than .02), and time to follow-up study (less than or equal to 15 days vs greater than 15 days) (4.8 +/- 5.8% vs 9.8 +/- 8.6%, p less than .03). Reperfusion time (less than or equal to 2 hr vs greater than 2 hr) predicted improvement when subtotal stenoses and stuttering infarctions were excluded (10.6 +/- 7.0% vs 4.9 +/- 6.9, p less than .03). Multivariate analysis showed initial ejection fraction and subtotal vs total stenosis to be independent predictors. Patients with anterior infarctions, low initial ejection fractions, and subtotal stenoses or reperfusion times less than or equal to 2 hr are likely to benefit most from coronary angioplasty for acute myocardial infarction. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text