Waktu antara angina dan tindakan percutaneous coronary intervention menyebabkan perubahan wall motion score index pada pasien infark miokard akut

2018 ◽  
Vol 49 (3) ◽  
Author(s):  
Ni Made Ayu Wulan Sari
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Wall Motion ◽  
Coronary Intervention ◽  
Wall Motion Score Index ◽  
Percutaneous Coronary ◽  
Score Index

Abstract P178: Echocardiographic Correlates of Persistent Q-Waves in Patients With ST-Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Mikhail Kirnus ◽  
Adeyemi Iyanoye ◽  
Elizabeth Hubbard ◽  
Mikhail Torosoff
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Wall Motion ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
History Of ◽  
St Elevation ◽  
Wall Motion Abnormalities

Background Historic data suggests 65-70% prevalence of Q-waves and concurrent wall motion abnormalities in patients with ST-elevation myocardial infarction (STEMI) treated with thrombolytics. We investigated prevalence of post-MI Q-waves and correlation between Q-waves and left ventricular wall motion abnormalities in STEMI patients treated with primary percutaneous coronary intervention (PCI). Study Design A retrospective study cohort included 145 patients (24% females, 57+/-13 years old) without prior Q-wave MI who underwent successful primary PCI for STEMI at a single academic tertiary center. New York State Angioplasty Registry endpoints were utilized. Echocardiograms and ECGs (median 53 days post STEMI) were reviewed for presence or absence of segmental wall motion abnormalities (WMAs) and Q-waves. ANOVA and chi-square analyses were performed. Results Prevalence of post PCI Q-waves in STEMI patients was 69%, similar to historic 64% in TIMI 14 trial patients (p=0.258). Timing of PCI was not a significant predictor of Q-waves, but there was a trend towards higher pre- and post-PCI creatine kinase and troponin levels in patients with Q-waves. Patients with history of hypertension were less likely to develop Q-waves (62% vs. 77%, p=0.048), while age, gender, history of CHF, COPD, diabetes, renal failure, smoking, and admission hemodynamic status were not predictive of post-PCI Q-waves. WMAs were present in 38% of patients with Q-waves vs. 9% in the rest of the cohort (p=0.0003). Q-waves were equally likely to develop regardless of location of ST elevations at presentation; however, WMAs were more likely in patients with Q-waves in leads II-III-AVF (p=0.008) and V1-2-3 (p<0.0001), V4-5-6 (p=0.008), but not I-AVL (p=0.07). Positive predictive value for WMAs in patients with Q waves was 38%, while negative predictive value for lack of WMAs in patients without Q waves was 91%. Conclusions Prevalence of Q waves, reflective of myocardial damage, in STEMI patients treated with primary coronary intervention is similar to such observed in thrombolysis trials. Positive predictive value of Q-waves for WMAs is low. In CAD patients without Q-waves segmental WMAs are unlikely.

scholarly journals ROLE OF SYNTAX SCORE SCALE IN THE STRATIFICATION OF THE NOSOCOMIAL RISK OF CARDIOVASCULAR COMPLICATIONS AND LETHALITY IN PATIENTS WITH ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION

2018 ◽  
Vol 14 (3) ◽  
pp. 324-329
Author(s):  
D. B. Nemik ◽  
G. V. Matyushin ◽  
S. A. Ustyugov
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Clinical Practice ◽  
Coronary Intervention ◽  
Left Ventricular Ejection ◽  
Syntax Score ◽  
St Segment Elevation ◽  
St Segment ◽  
Percutaneous Coronary ◽  
Score Index

The lethality of patients with acute myocardial infarction with ST-segment elevation (STEMI) depends on many factors. In conditions of timely transportation of the patient to the center of percutaneous coronary intervention one of these factors is the severity of the coronary bed lesion. In clinical practice, the most common method of assessing such lesions is the SYNTAX Score scale.Aim. To study the impact of the assessment by angiographic SYNTAX Score scale on in-hospital complications and lethality in patients with STEMI.Material and methods. The single-center observational retrospective study was performed. The medical data of 816 cases of treatment of patients with STEMI in the first 6 hours from the onset of symptoms were analyzed. All patients underwent reperfusion therapy (primary percutaneous coronary intervention or pharmacoinvasive strategy (FIS)) with assessment of the SYNTAX Score index prior to intervention. The main group (SYNTAX Score ≤22 points) and the comparison group (SYNTAX Score index >22 points) were comparable in terms of clinical characteristics and time delays.Results. An increase in the SYNTAX Score more than 22 points was an independent predictor of hospital complications and lethality (4.9% for SYNTAX Score ≤22 points and 21.9% – for >22 points). The group with a high SYNTAX index was older, had a higher proportion of smokers (46.8% vs 36.1%, p=0.015) and patients with myocardial infarction history (38.5% vs 20.6%, p<0.001), fewer patients to whom the FIS was applied (33.3% vs 45.7%; p=0.017). Nevertheless, in multivariate analysis, the initial clinical data of patients influenced the hospital prognosis, first of all in patients with SYNTAX Score ≤22 points. The group with a more severe lesion of the coronary bed was represented by patients with frequent development of pulmonary edema, cardiogenic shock and ventricular fibrillation. Cardiac complications in this group of patients were less dependent on the initial characteristics. Strong SYNTAX Score correlations were found with left ventricular ejection fraction (r=-0.156, p<0.001), the number of implanted stents (r=0.226, p<0.001), and with complications and lethality. The frequency of hemorrhagic complications did not depend on the severity of the coronary bed lesion.Conclusion. The use of the SYNTAX Score scale in clinical practice is scientifically grounded and advisable. Stratification of high-risk patients with STEMI during primary angiography based on the SYNTAX Score scale has a high prognostic value. 

Abstract 2664: Clinical Outcome and Left Ventricular Contractile Function After Distal Protection in Primary Percutaneous Coronary Intervention The Drug Elution and Distal Protection in ST-Elevation Myocardial Infarction (DEDICATION) Trial

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Klaus F Kofoed ◽  
Henning Kelbæk ◽  
Leif Thuesen ◽  
Steen H Poulsen ◽  
Christian Hassager ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Clinical Outcome ◽  
Wall Motion ◽  
Contractile Function ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Lv Function ◽  
Percutaneous Coronary ◽  
Distal Protection

Objective Embolization of material from an infarct-related lesion during percutaneous coronary intervention (PCI) may result in an increased infarct size. We evaluated the effect of distal protection during PCI for ST-segment elevation myocardial infarction (STEMI) on clinical outcome and myocardial function. Methods and results Patients with STEMI were randomly referred within 12 hours for PCI with (n = 312) or without distal protection (n = 314). Left ventricular (LV) contractile function was assessed with echocardiography 8 month after PCI. Global LV myocardial wall motion index (WMI) was calculated as the average wall motion score of all myocardial segments. Major adverse cardiac and cerebral events (MACCE) 8 months after PCI was 7.1 % after distal protection and 5.7 % after conventional treatment (p = 0.17). WMI improved by 4.1% at 8 months in patients treated with distal protection compared to patients receiving conventional PCI (p<0.01). In myocardium subtended by culprit coronary vessels treated with distal protection regional LV function was 9 –11% higher than myocardial regions treated conventionally (p<0.02). Conclusion Routine use of distal protection during primary PCI is associated with a significant improvement in LV contractile function, with no detectable impact on intermediate term clinical outcome.

Serial speckle tracking and successful post-STEMI percutaneous coronary intervention: incremental value versus visual wall motion analysis

2010 ◽  
Vol 11 (10) ◽  
pp. 768-771 ◽  
Author(s):  
Vincenzo Schiano Lomoriello ◽  
Maurizio Galderisi ◽  
Antonio Rapacciuolo ◽  
Alessandro Santoro ◽  
Gennaro Maresca ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Motion Analysis ◽  
Speckle Tracking ◽  
Wall Motion ◽  
Coronary Intervention ◽  
Wall Motion Analysis ◽  
Incremental Value ◽  
Percutaneous Coronary
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