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Titolo:
IMPORTANCE OF INFARCT-RELATED ARTERY PATENCY FOR RECOVERY OF LEFT-VENTRICULAR FUNCTION AND LATE SURVIVAL AFTER PRIMARY ANGIOPLASTY FOR ACUTE MYOCARDIAL-INFARCTION
Autore:
BRODIE BR; STUCKEY TD; KISSLING G; HANSEN CJ; WEINTRAUB RA; KELLY TA;
Indirizzi:
520 N ELAM AVE GREENSBORO NC 27401 UNIV N CAROLINA,DEPT MATH SCI,DIV STAT GREENSBORO NC 27412 MOSES CONE MEM HOSP,DEPT MED GREENSBORO NC 00000 LEBAUER CARDIOVASC RES FDN GREENSBORO NC 00000
Titolo Testata:
Journal of the American College of Cardiology
fascicolo: 2, volume: 28, anno: 1996,
pagine: 319 - 325
SICI:
0735-1097(1996)28:2<319:IOIAPF>2.0.ZU;2-S
Fonte:
ISI
Lingua:
ENG
Soggetto:
12-MONTH FOLLOW-UP; THROMBOLYTIC THERAPY; CORONARY THROMBOLYSIS; REPERFUSION; LIMITATION; PREVENTION; SALVAGE; TRIAL;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
24
Recensione:
Indirizzi per estratti:
Citazione:
B.R. Brodie et al., "IMPORTANCE OF INFARCT-RELATED ARTERY PATENCY FOR RECOVERY OF LEFT-VENTRICULAR FUNCTION AND LATE SURVIVAL AFTER PRIMARY ANGIOPLASTY FOR ACUTE MYOCARDIAL-INFARCTION", Journal of the American College of Cardiology, 28(2), 1996, pp. 319-325

Abstract

Objectives. The purpose of this study was to evaluate the importance of late infarct-related artery patency for recovery of left ventricular function and late survival after primary angioplasty for acute myocardial infarction, Background. Infarct-related artery patency is thought to improve late survival by its effect on preservation of left ventricular function. Patency may also enhance late survival by preventing left ventricular dilation and reducing arrhythmias, independent of myocardial salvage. However, most studies have not shown patency to be anindependent predictor of survival when late left ventricular functionis taken into account. Methods. We followed up 576 hospital survivorsof acute myocardial infarction treated with primary angioplasty for 5.3 years. Ejection fraction and infarct-related artery patency were determined at follow-up catheterization at 6 months. Predictors of late cardiac survival were determined using Cox regression mod els. Results. Patients with patent arteries had more improvement and a better lateejection fraction than patients with occluded arteries (56.3% vs. 47.9%, p = 0.001). In patients with acute ejection fraction <45%, late survival was better in those with patent versus occluded arteries (89% vs. 44%, p = 0.003), but patency was not a significant predictor after improvement in ejection fraction was taken into account. In patients with a large anterior infarction, patency was a significant independentpredictor of late survival. Conclusions. Infarct-related artery patency is important for recovery of left ventricular function, and in patients with acute ejection fraction <45%, patency is important for late survival. Our data are consistent with the hypothesis that the survival benefit is due primarily to the effect of patency on recovery of left ventricular function, In patients,vith a large anterior infarction, patency appears to provide an additional late survival benefit independent of myocardial salvage, These observations support the need for additional clinical trials of late reperfusion in patients with a large anterior infarction.

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Documento generato il 05/12/20 alle ore 10:32:50