Clinical and Angiographic Prophesy of Hemodynamic Status in Patients with Acute Anterior Wall ST-Segment-Elevation Myocardial Infarction and Totally Occluded Left Anterior Descending Artery
| Autor: | Amit Shah, Parminder S Otaal, Ashwani Sood, Arnab Pal, Akash Batta |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Hemodynamics occlusion STEMI left anterior descending artery Internal medicine Diabetes mellitus Occlusion Internal Medicine medicine ST segment Myocardial infarction Original Research Ejection fraction biology business.industry hemodynamic stability clinical predictors medicine.disease angiographic Troponin medicine.anatomical_structure Integrated Blood Pressure Control Cardiology biology.protein Cardiology and Cardiovascular Medicine business Artery |
| Zdroj: | Integrated Blood Pressure Control |
| ISSN: | 1178-7104 |
| Popis: | Parminder Singh Otaal,1 Amit Shah,2 Akash Batta,3 Ashwani Sood,4 Arnab Pal5 1Department of Cardiology, Advanced Cardiac Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India; 2Department of Internal Medicine, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India; 3Department of Cardiology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India; 4Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India; 5Department of Biochemistry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, IndiaCorrespondence: Parminder Singh OtaalDepartment of Cardiology, Advanced Cardiac Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, 160012, Punjab, IndiaTel +91 9814526747Email psotaal@gmail.comBackground: Left anterior descending artery (LAD) is the most common occluded vessel in a patient presenting with acute anterior wall ST-segment elevated myocardial infarction (STEMI). Acute occlusion of LAD usually results in hemodynamic compromise. However, some patients maintain hemodynamic stability despite its proximal occlusion. As the factors associated with hemodynamic status in such patients are poorly understood, our study sought to determine the clinical and angiographic parameters associated with hemodynamic stability in these patients.Methods: In this prospective observational study, 60 consecutive patients of acute anterior wall STEMI with completely occluded LAD on coronary angiography were included. Various clinical and angiographic parameters associated with hemodynamic status were evaluated.Results: Of the 60 patients, 30 patients each were included in the hemodynamically stable (group I) and hemodynamically unstable group (group II). The mean age of the patients in group I and group II was 51.07± 13.78 years and 55.47± 11.69 years, respectively. The hemodynamically unstable group had a significantly higher number of patients with diabetes mellitus, elevated Troponin T level, and lower left ventricular ejection fraction as compared to the stable group (p< 0.05). In contrast, 11 (36.7%) patients in the hemodynamically stable group had rich collaterals compared to 4 (13.3%) patients in the hemodynamically unstable group. The difference was statistically significant (p=0.037).Conclusion: The present study showed that the presence of diabetes, severe LV systolic dysfunction, elevated Troponin-T level, and poor collaterals were associated with hemodynamic instability, whereas the presence of better collaterals predicted hemodynamic stability in patients presenting with anterior wall STEMI and total LAD occlusion.Keywords: STEMI, left anterior descending artery, occlusion, hemodynamic stability, angiographic, clinical predictors |
| Databáze: | OpenAIRE |
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