Association of noninvasive markers of coronary artery reperfusion to assess microvascular obstruction in patients with acute myocardial infarction treated with primary angioplasty

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dc.contributor.authorCorbalan, R
dc.contributor.authorLarrain, G
dc.contributor.authorNazzal, C
dc.contributor.authorCastro, PF
dc.contributor.authorAcevedo, M
dc.contributor.authorDominguez, JM
dc.contributor.authorBellolio, F
dc.contributor.authorKrucoff, MW
dc.date.accessioned2024-01-10T13:46:10Z
dc.date.available2024-01-10T13:46:10Z
dc.date.issued2001
dc.description.abstractEarly restoration of coronary artery patency through primary angioplasty limits infarct size and improves survival. Increasing evidence, however, suggests that microvascular obstruction is often present despite coronary artery recanalization. This may limit the benefits of reperfusion therapy. We studied the use of noninvasive markers of coronary artery reperfusion as indicators of microvascular obstruction and determinants of prognosis in 98 patients with acute myocardial infarction (AW) who were successfully treated with primary angioplasty (Thrombolysis In Myocardial Infarction grade 3 flow and residual stenosis < 30%). Plasma creatine kinase (CK) levels and 12-lead electrocardiograms were performed on admission, at 90 minutes, and at 6, 12, and 24 hours after treatment. We defined: (1) reperfusion as resolution of ST-segment elevation > 50% at 90 minutes, with peak CK levels within 12 hours, and T-wave inversion within 24 hours; and (2) failed reperfusion, as the absence of these parameters. Of the 98 patients studied, 87 (88.8%) had reperfusion and 11 (11.2%) had failed reperfusion. Infarct location was anterior (versus inferior) in 9 patients in the failed reperfusion group (81.8%) compared with 41 patients in the reperfusion group (47.1%) (p < 0.01). Congestive heart failure > 24 hours after presentation or in-hospital death occurred in 11 patients (12.6%) in the reperfusion group versus 5 (45.5%) in the failed reperfusion group (p < 0.01). One-year survival was 96.1% for the reperfusion group and 60.6% for the failed reperfusion group (p < 0.0001). We conclude that the association of noninvasive markers of reperfusion better identifies patients with microvascular obstruction among those who had a "successful" primary angioplasty. Evidence of impaired microvascular reperfusion is associated with a poor in-hospital and 1-year outcome. (C) 2001 by Excerpta Medica, Inc.
dc.fechaingreso.objetodigital16-04-2024
dc.format.extent5 páginas
dc.fuente.origenWOS
dc.identifier.doi10.1016/S0002-9149(01)01676-9
dc.identifier.issn0002-9149
dc.identifier.pubmedidMEDLINE:11545751
dc.identifier.urihttps://doi.org/10.1016/S0002-9149(01)01676-9
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/79129
dc.identifier.wosidWOS:000170344300002
dc.information.autorucMedicina;Acevedo M;S/I;81173
dc.information.autorucMedicina;Castro P;S/I;100212
dc.information.autorucMedicina;Corbalán R;S/I;98700
dc.issue.numero4
dc.language.isoen
dc.nota.accesoContenido parcial
dc.pagina.final346
dc.pagina.inicio342
dc.publisherEXCERPTA MEDICA INC
dc.revistaAMERICAN JOURNAL OF CARDIOLOGY
dc.rightsacceso restringido
dc.subjectST-SEGMENT ELEVATION
dc.subjectNO-REFLOW PHENOMENON
dc.subjectPROGNOSTIC IMPLICATIONS
dc.subjectTHROMBOLYTIC THERAPY
dc.subjectBEDSIDE MARKERS
dc.subjectPOOR RECOVERY
dc.subjectRESOLUTION
dc.subjectPERFUSION
dc.subjectPREDICTOR
dc.subjectSTANDARD
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleAssociation of noninvasive markers of coronary artery reperfusion to assess microvascular obstruction in patients with acute myocardial infarction treated with primary angioplasty
dc.typeartículo
dc.volumen88
sipa.codpersvinculados81173
sipa.codpersvinculados100212
sipa.codpersvinculados98700
sipa.indexWOS
sipa.trazabilidadCarga SIPA;09-01-2024
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