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Titolo:
INFLUENCE OF LATE REOPENING OF THE INFARCT-RELATED ARTERY ON LEFT-VENTRICULAR REMODELING AFTER MYOCARDIAL-INFARCTION
Autore:
MENEVEAU N; BASSAND JP; BAUTERS C; ROZAND JY; PETIT JL; BEURRIER D; GROLLIER G; ANDRE F; VAHANIAN A; VIEL JF;
Indirizzi:
HOP UNIV ST JACQUES,2 PL ST JACQUES F-25030 BESANCON FRANCE HOP CARDIOL F-59037 LILLE FRANCE HOP UNIV SABOURIN CLERMONT FERRAN FRANCE HOP TRONCHE GRENOBLE FRANCE HOP UNIV BRABOIS NANCY FRANCE HOP UNIV COTE NACRE CAEN FRANCE HOP UNIV TENON PARIS FRANCE HOP BOCAGE DIJON FRANCE HOP ST JACQUES,DEPT INFORMAT & STAT F-25030 BESANCON FRANCE
Titolo Testata:
European heart journal
fascicolo: 8, volume: 18, anno: 1997,
pagine: 1261 - 1268
SICI:
0195-668X(1997)18:8<1261:IOLROT>2.0.ZU;2-W
Fonte:
ISI
Lingua:
ENG
Soggetto:
TISSUE PLASMINOGEN-ACTIVATOR; LATE CORONARY REPERFUSION; 12-MONTH FOLLOW-UP; THROMBOLYTIC THERAPY; RANDOMIZED TRIAL; TIMI TRIAL; PHASE-I; ANGIOPLASTY; SURVIVAL; PATENCY;
Keywords:
LEFT VENTRICULAR REMODELING; CORONARY PATENCY; CORONARY ANGIOPLASTY; CORONARY REOPENING;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
37
Recensione:
Indirizzi per estratti:
Citazione:
N. Meneveau et al., "INFLUENCE OF LATE REOPENING OF THE INFARCT-RELATED ARTERY ON LEFT-VENTRICULAR REMODELING AFTER MYOCARDIAL-INFARCTION", European heart journal, 18(8), 1997, pp. 1261-1268

Abstract

Aims This trial was undertaken to assess the impact of late reopeningof the infarct-related artery on left ventricular remodelling in post-myocardial infarction patients. Methods One hundred and fifty seven patients with recent myocardial infarction were routinely submitted to delayed (second week) catheterization. They also underwent systematic angioplasty of a significantly narrowed infarct-related artery with a suitable anatomy, or reopening of a totally occluded infarct-related artery, and repeat follow-up catheterization after 4 months. Changes inleft ventricular ejection fraction, left ventricular volumes, and percent of regional hypokinesia were assessed over the study period. Results One hundred and thirty-two patients had two interpretable left ventriculograms and two interpretable coronary angiograms. At initial angiography, 56 out of 96 patients with a patent infarct-related artery were successfully submitted to percutaneous coronary angioplasty, of whom 25 had restenosis and eight had total reocclusion at follow-up angiography. Percutaneous transluminal coronary angioplasty was not attempted in the remaining 40 patients due to unsuitable anatomy in 18 or a nonsignificant lesion in 22. The infarct-related artery was totally occluded in 36 patients at initial angiography, and successfully reopened by means of angioplasty in 19, of whom seven showed a reocclusion atfollow-up angiography. The independent predictors of left ventricularenlargement: identified by means of multivariate regression analysis,were initial stroke volume index <40 ml.m(-2) (odds ratio=6.3, 95% confidence interval=[2.5; 16.6]), initial end-systolic Volume index >50 ml.m(-2) (odds ratio=7.1, 95% confidence interval=[1.5; 25.8]), anterior infarct location (odds ratio=4.1, 95% confidence interval= [1.4; 11.5]) and reocclusion of the infarct-related artery (odds ratio=7.3, 95% confidence interval=[1.3; 27.3]). Angioplasty of a patent but significantly narrowed infarct-related artery was not found predictive. Conclusions This study demonstrates that reocclusion of a previously open infarct-related artery, as well as the initial low stroke volume index, enlarged end-systolic volume index and anterior infarct location areindependent predictors of long-term left ventricular enlargement. These results emphasize the impact of long-term sustained patency of the infarct-related artery on the prevention of left ventricular dysfunction. The need for a larger randomized trial is recognised.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/12/20 alle ore 08:50:12