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Titolo:
LONG-TERM PROGNOSTIC IMPORTANCE OF PATENCY OF THE INFARCT-RELATED CORONARY-ARTERY AFTER THROMBOLYTIC THERAPY FOR ACUTE MYOCARDIAL-INFARCTION
Autore:
WHITE HD; CROSS DB; ELLIOTT JM; NORRIS RM; YEE TW;
Indirizzi:
GREEN LANE HOSP,CARDIOVASC RES UNIT AUCKLAND 1003 NEW ZEALAND GREEN LANE HOSP,CORONARY CARE UNIT AUCKLAND NEW ZEALAND UNIV AUCKLAND,DEPT MATH AUCKLAND NEW ZEALAND
Titolo Testata:
Circulation
fascicolo: 1, volume: 89, anno: 1994,
pagine: 61 - 67
SICI:
0009-7322(1994)89:1<61:LPIOPO>2.0.ZU;2-H
Fonte:
ISI
Lingua:
ENG
Soggetto:
TISSUE PLASMINOGEN-ACTIVATOR; LEFT-VENTRICULAR FUNCTION; 12-MONTH FOLLOW-UP; INTRAVENOUS STREPTOKINASE; TIMI TRIAL; PHASE-I; SURVIVAL; DETERMINANT; REPERFUSION; PREVENTION;
Keywords:
MORTALITY; PLASMINOGEN ACTIVATORS; STREPTOKINASE; VENTRICLES;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
42
Recensione:
Indirizzi per estratti:
Citazione:
H.D. White et al., "LONG-TERM PROGNOSTIC IMPORTANCE OF PATENCY OF THE INFARCT-RELATED CORONARY-ARTERY AFTER THROMBOLYTIC THERAPY FOR ACUTE MYOCARDIAL-INFARCTION", Circulation, 89(1), 1994, pp. 61-67

Abstract

Background After thrombolytic therapy, long-term patency of the infarct-related artery may reduce arrhythmias, limit ventricular dilatation, and provide collaterals to another infarct zone if further infarction occurs. However, independent long-term prognostic value of infarct artery patency has not been shown.Methods and Results We followed 312 patients with first myocardial infarction treated <4 hours after pain onset with thrombolysis (streptokinase [n=188] or recombinant tissue-type plasminogen activator [n=124]). At 28+/-11 days, cardiac catheterization was performed. Flow of the infarct-related artery was assessed by the TIMI scoring system, and a scoring system relating coronary stenoses and how to the amount of myocardium supplied was also used. Follow-up was for 39+/-13 months. Cardiac death occurred in 5.8% of patients, and there were two noncardiac deaths. Revascularization was performed in 11.5% of patients. On univariate and multivariate analysis, ventricular function (ejection fraction, P=.006 and .02, or end-systolic volume index, P=.01 and .06) was the most important prognostic factor. Patency of the infarct-related artery measured as TIMI 3 flow was marginally significant on univariate analysis (P=.O8) but not on multivariate analysis (P=.2). Patency was an independent prognostic factor in univariate and multivariate analysis when measured as an occlusion score (amount of myocardium supplied by an occluded artery, P=.01 and <.05). When the ejection fraction was greater than or equal to 50%, only occluded arteries supplying >25% of the left ventricle affected prognosis adversely. If the ejection fraction was <50%, occluded arteries supplying <25% of myocardium also adversely affected prognosis. Treadmillexercise duration 4 weeks after infarction was the only other prognostic factor identified. Conclusions Ventricular function and infarct-related artery patency are independent prognostic factors after thrombolytic therapy for acute myocardial infarction.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/12/20 alle ore 08:57:12