Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
Early noninvasive detection of failed epicardial reperfusion after fibrinolytic therapy
Autore:
de Lemos, JA; Morrow, DA; Gibson, CM; Murphy, SA; Rifai, N; Tanasijevic, M; Giugliano, RP; Schuhwerk, KC; McCabe, CH; Cannon, CP; Antman, EM; Braunwald, E;
Indirizzi:
Univ Texas, SW Med Ctr, Dallas, TX USA Univ Texas Dallas TX USAUniv Texas, SW Med Ctr, Dallas, TX USA Donald W Reynolds Cardiovasc Clin Res Ctr, Dallas, TX USA Donald W Reynolds Cardiovasc Clin Res Ctr Dallas TX USA , Dallas, TX USA Brigham & Womens Hosp, Dept Med, Boston, MA 02115 USA Brigham & Womens Hosp Boston MA USA 02115 Dept Med, Boston, MA 02115 USA Brigham & Womens Hosp, Clin Labs, Boston, MA 02115 USA Brigham & Womens Hosp Boston MA USA 02115 Clin Labs, Boston, MA 02115 USA Harvard Univ, Clin Res Inst, Boston, MA 02115 USA Harvard Univ Boston MA USA 02115 niv, Clin Res Inst, Boston, MA 02115 USA Childrens Hosp, Boston, MA 02115 USA Childrens Hosp Boston MA USA 02115Childrens Hosp, Boston, MA 02115 USA
Titolo Testata:
AMERICAN JOURNAL OF CARDIOLOGY
fascicolo: 4, volume: 88, anno: 2001,
pagine: 353 - 358
SICI:
0002-9149(20010815)88:4<353:ENDOFE>2.0.ZU;2-G
Fonte:
ISI
Lingua:
ENG
Soggetto:
ACUTE MYOCARDIAL-INFARCTION; CREATINE-KINASE-MB; CORONARY-ARTERY PATENCY; ST-SEGMENT RESOLUTION; THROMBOLYTIC THERAPY; INTRAVENOUS THROMBOLYSIS; BIOCHEMICAL MARKERS; CLINICAL-VARIABLES; BEDSIDE MARKERS; SERUM MYOGLOBIN;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
29
Recensione:
Indirizzi per estratti:
Indirizzo: de Lemos, JA Univ Texas, SW Med Sch, 5323 Harry Hines Bldg,Room H8-116, Dallas, TX 75390 USA Univ Texas 5323 Harry Hines Bldg,Room H8-116 Dallas TX USA 75390
Citazione:
J.A. de Lemos et al., "Early noninvasive detection of failed epicardial reperfusion after fibrinolytic therapy", AM J CARD, 88(4), 2001, pp. 353-358

Abstract

Available noninvasive techniques for identifying patients with failed epicardial reperfusion after fibrinolytic therapy are limited by poor accuracy. It is unknown whether combining multiple noninvasive predictors would improve diagnostic accuracy and facilitate identification of candidates for rescue percutaneous coronary intervention. In the Thrombolysis In Myocardial Infarction (TIMI) 14 trial, we evaluated the ability of ST-segment resolution (n = 606), chest pain resolution (n = 859), and the ratio of 60-minute/baseline serum myoglobin (n = 308) to identify patients with angiographic evidence of failed reperfusion 90 minutes after fibrinolysis. Three criteria were prospectively defined: < 50% ST resolution at 90 minutes, presence of chest pain at the time of angiography, and myoglobin ratio < 4. Patients whomet any individual criterion were more likely to have less than TIMI 3 flow and an occluded infarct-related artery (TIMI 0/1 flow) than those who didnot meet the criterion (p < 0.005 for each). When the 3 criteria were usedtogether (n = 169), patients who satisfied 0 (n = 29), 1 (n = 68), 2 (n = 51), or 3 (n = 21) of the criteria had a 17%, 24%, 35%, and 76% probabilityof failing to achieve TIMI 3 flow (p < 0.0001 for trend), a 0%, 6%, 18%, and 57% probability of an occluded infarct-related artery (p < 0.0001 for trend), and a 0%, 1.5%, 2.0%, and 9.5% rate of 30-day mortality (p = 0.05 fortrend), respectively. Use of the criteria in combination increased positive predictive values without decreasing negative predictive values. In conclusion, ST-segment resolution, chest pain resolution, and early washout of serum myoglobin can be used in combination to aid in the early noninvasive identification of candidates for rescue percutaneous coronary intervention. (C) 2001 by Excerpta Medica, Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 19/09/20 alle ore 19:47:53