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Titolo:
Prognosis of acute myocardial infarction in the thrombolytic era: medical evaluation is still valuable
Autore:
Nicolau, JC; Serrano, CV; Garzon, SAC; Ramires, JAF;
Indirizzi:
Univ Sao Paulo, Sch Med, Inst Heart InCor, Sao Paulo, Brazil Univ Sao Paulo Sao Paulo Brazil ed, Inst Heart InCor, Sao Paulo, Brazil Inst Molestias Cardiovasc, Sao Paulo, Brazil Inst Molestias Cardiovasc Sao Paulo Brazil ardiovasc, Sao Paulo, Brazil
Titolo Testata:
EUROPEAN JOURNAL OF HEART FAILURE
fascicolo: 5, volume: 3, anno: 2001,
pagine: 569 - 576
SICI:
1388-9842(200110)3:5<569:POAMII>2.0.ZU;2-O
Fonte:
ISI
Lingua:
ENG
Soggetto:
LEFT-VENTRICULAR FUNCTION; CONGESTIVE-HEART-FAILURE; INTRAVENOUS STREPTOKINASE; FOLLOW-UP; PLASMINOGEN-ACTIVATOR; PHASE-I; THERAPY; REPERFUSION; TRIAL; DETERMINANTS;
Keywords:
acute myocardial infarction; medical evaluation; long-term follow-up; thrombolysis;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
36
Recensione:
Indirizzi per estratti:
Indirizzo: Nicolau, JC Rue Aureliano Coutinho 355, BR-01224020 Sao Paulo, Brazil RueAureliano Coutinho 355 Sao Paulo Brazil BR-01224020 BCil
Citazione:
J.C. Nicolau et al., "Prognosis of acute myocardial infarction in the thrombolytic era: medical evaluation is still valuable", EUR J HE FA, 3(5), 2001, pp. 569-576

Abstract

Background Modern and sophisticated technology for the management of myocardial infarction has progressively devalued medical evaluation. Hypothesis:This study was undertaken to assess the importance of the findings of medical evaluation at hospital presentation, in patients with acute myocardial infarction. Methods: Data from 590 thrombolytic- treated myocardial infarction patients were analyzed. The patients were grouped according to their clinical status on arrival at hospital. A modified Forrester classification -subset IT was divided according to the absence (IIa) or presence (IIb) of symptoms - was applied. Short- (14 days) and long-term (up to 10 years) survival was analyzed and 19 independent variables were included in the multivariate models. Results: Short-term survival was 95.6% for subset I, 83.3% for subset IIa, 60% for subset IIb, 54.6% for subset III, and 34.8% for subset IV (P < 0.001). By multiple regression analysis, lower clinical subsets (P < 0.001), fewer coronary arteries with disease (P = 0.006), younger age (P = 0.014), absence of reinfarction (P = 0.034), longer interval between streptokinase infusion and coronary arteriography (P = 0.016), and higher left ventricular ejection fraction (P = 0.037) demonstrated significant and independent correlation with short-term survival. Long-term survival for thetotal population was 71 +/- 3.6% for subset I, 54.4 +/- 8.5% for subset IIa, 20.8 +/- 9.4% for subset IIb, 54.5 +/- 15% for subset III, and 0% for subset IV (P < 0.001). Using Cox regression analysis, lower clinical subsets (P < 0.001), younger age (P <less than> 0.001), higher global left ventricular ejection fraction (P < 0.001), and fewer coronary arteries with disease(P = 0.021) correlated independently and significantly with long-term survival. When excluding data from patients who died before the short-term follow-up (n = 532), lower clinical subsets remained an important predictor of long-term survival (P < 0.001). Conclusion: Clinical classification at hospital presentation is a powerful predictor of short- and long-term survival post-myocardial infarction. (C) 2001 European Society of Cardiology. All rights reserved.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/01/20 alle ore 03:22:13