The comparison of revalcularization outcomes in acute coronary syndrom following primary coronary angioplasty

Purpose. To compare clinical and morphofunctional outcomes of revascularization in patients after primary coronary angioplasty with different degree of coronary arteries damage and type of myocardial infarction. Material and methods. The research involved 258 patients after myocardial infarction who underwent coronary balloon angioplasty with stenting infarct-related artery. By electrocardiographic and angiographic picture all patients were divided into 4 groups: Q-wave myocardial infarction and without Q-wave myocardial infarction with single-vessel and multivessel disease. Results. The study found that the patients with non Q-wave myocardial infarction and single-vessel disease had no adverse clinical outcomes during a year. The wall motion index and the ejection fraction almost recovered completely (wall motion index varied from 1.18 0.02 to 1.05 0.02 and ejection fraction from 57.4 0.5% to 63.3 0.6%; р 0.001). All the patients with Q-wave myocardial infarction revealed similar clinical outcomes and morphofunctional characteristics. The group of patients with non Q-wave and multivessel disease had the highest rate of adverse clinical outcomes with progressing left-ventricular disfunction according to echocardiography (wall motion index varied from 1.15 0.01 to 1.19 0.04 and ejection fraction from 53.9 0.5% to 55.1 0.6%; р 0.001). Conclusion. The degree of coronary arteries damage in the patients with Q myocardial infarction did not influence postinfarction remodeling and long-term cardiac outcomes. The patients with non-Q myocardial infarction and single-vessel disease had fewer signs of postinfarction remodeling and complications in postinfarction period. The worst prognosis was revealed by patients with similar forms of myocardial infarction and multivessel disease.

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Impact of diabetes mellitus on long term survival after acute myocardial infarction in patients with single vessel disease

Heart ◽

10.1136/hrt.86.2.133 ◽

2001 ◽

Vol 86 (2) ◽

pp. 133-138

Author(s):

M Ishihara ◽

H Sato ◽

T Kawagoe ◽

Y Shimatani ◽

S Kurisu ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Wilcoxon Test ◽

Multivessel Disease ◽

Diabetic Patients ◽

City Hospital ◽

Vessel Disease ◽

Single Vessel ◽

Single Vessel Disease

OBJECTIVETo assess the influence of diabetes on long term prognosis after reperfusion treatment and its interaction with multivessel disease.DESIGNA retrospective observational study.SETTINGHiroshima City Hospital.PATIENTS1660 consecutive patients with acute myocardial infarction who underwent coronary angiography within 24 hours after the onset of chest pain.MAIN OUTCOME MEASURESInfluence of diabetes on 10 year survival after infarction was assessed using the generalised Wilcoxon test and Cox's proportional hazards regression. Follow up was completed in 1622 patients (98%).RESULTSDiabetic patients had more multivessel disease than non-diabetic patients (53%v 34%, p < 0.001). When only patients with single vessel disease were compared, diabetes was associated with a reduced 10 year survival after infarction (p = 0.002). On the other hand, in patients with multivessel disease there was no significant difference in survival between diabetic and non-diabetic patients (p = 0.70). Multivariate analysis also showed that diabetes was an independent risk factor related to 10 year mortality after infarction in patients with single vessel disease (odds ratio (OR) 1.81, 95% confidence interval (CI) 1.27 to 2.54; p = 0.001) and not in patients with multivessel disease (OR 1.17, 95% CI 0.85 to 1.60; p = 0.34).CONCLUSIONSDiabetes is an independent predictor of long term mortality after infarction in patients with single vessel disease. However, in the presence of multivessel disease, prognosis after infarction is impaired regardless of diabetes, and the influence of diabetes is less obvious.

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301 Importance of the systolic wall motion dysfunction localization for reduction of left ventricular ejection fraction in patients with acute myocardial infarction

European Journal of Echocardiography ◽

10.1016/s1525-2167(99)80170-x ◽

1999 ◽

Vol 1 ◽

pp. S50-S50

Author(s):

A KISSIOV ◽

I IVANOV ◽

L PENEVA ◽

N SIMEONOVA ◽

E BOGOUSHEVA ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Left Ventricular Ejection Fraction ◽

Ejection Fraction ◽

Wall Motion ◽

Left Ventricular ◽

Ventricular Ejection ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction

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Wall motion score index and ejection fraction for risk stratification after acute myocardial infarction

American Heart Journal ◽

10.1016/j.ahj.2005.03.042 ◽

2006 ◽

Vol 151 (2) ◽

pp. 419-425 ◽

Cited By ~ 138

Author(s):

Jacob E. Møller ◽

Graham S. Hillis ◽

Jae K. Oh ◽

Guy S. Reeder ◽

Bernard J. Gersh ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Ejection Fraction ◽

Risk Stratification ◽

Wall Motion ◽

Wall Motion Score Index ◽

Score Index

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Genetic and nongenetic factors in assessing the prognosis of patients after myocardial infarction with high medical adherence

CARDIOVASCULAR THERAPY AND PREVENTION ◽

10.15829/1728-8800-2021-2773 ◽

2021 ◽

Vol 20 (4) ◽

pp. 2773

Author(s):

K. G. Pereverzeva ◽

S. S. Yakushin ◽

A. S. Galus ◽

A. R. Shanina

Keyword(s):

Myocardial Infarction ◽

Left Ventricular Ejection Fraction ◽

Ejection Fraction ◽

Composite Endpoint ◽

Left Ventricular ◽

Ventricular Ejection ◽

Left Ventricular Ejection ◽

Medical Adherence ◽

Ventricular Ejection Fraction ◽

Q Wave

Aim. During one-year follow-up, to assess the effect of genetic and nongenetic factors on the risk of poor outcomes in patients after myocardial infarction (MI) with high medical adherence.Material and methods. The study included 250 patients admitted to the hospital due to MI in the period from September 1, 2018 to May 1, 2019 and with a potentially high medical adherence. Twelve months after MI, patients were assessed for adherence to therapy and the effect of genetic and nongenetic factors on the patient prognosis.Results. Within 12 months after MI, 70 (28,0%) patients had a composite endpoint: all-cause death, MI, cerebral stroke, and nonelective coronary revascularization. There were following factors increasing the risk of composite endpoint: non-Q-wave MI (relative risk (RR), 2,63; 95% confidence interval (CI): 1,63-4,25 (p=0,001); left ventricular ejection fraction ≤35% — RR, 2,03; 95% CI: 1,17-3,50 (p<0,0001); CYP2C19 GA/AA genotype (RR, 1,58; 95% CI: 1,06-2,37 (p<0,00001)).Conclusion. The study results allow identifying patients with a high risk of poor outcome: patients with non-Q-wave MI, left ventricular ejection fraction ≤35%, and CYP2C19 GA/AA genotype.

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Abstract 13917: Post-systolic Shortening in the Ischemic Myocardium is Attenuated in Multivessel Disease

Circulation ◽

10.1161/circ.132.suppl_3.13917 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Daisuke Sakurai ◽

Toshihiko Asanuma ◽

Kasumi Masuda ◽

Masamichi Oka ◽

Koichiro Kotani ◽

...

Keyword(s):

Coronary Artery ◽

Disease Model ◽

Left Ventricular ◽

Ischemic Myocardium ◽

Multivessel Disease ◽

Vessel Disease ◽

Single Vessel ◽

The Difference ◽

The Relationship ◽

Single Vessel Disease

Background: Post-systolic shortening (PSS) is myocardial shortening that occurs after end-systole and is considered as a sensitive marker of myocardial ischemia. Empirically, PSS in patients with multivessel disease is smaller than that in those with single vessel disease. Although this seems to be due to a decrease of difference in contraction between the ischemic and the surrounding myocardium, no study has elucidated it. We investigated the relationship between PSS and the difference of contraction between the ischemic and surrounding myocardium in an animal model which underwent left anterior descending coronary artery (LAD) occlusion (single vessel disease model) followed by left circumflex coronary artery (LCx) occlusion (multivessel disease model). Methods: In 7 open-chest dogs, left ventricular short-axis images (GE Vivid E9) and hemodynamic data were acquired at 3 conditions: (1) at baseline, (2) during LAD occlusion, and (3) during both LAD and LCx occlusion. Circumferential strains were analyzed in 6 segments by speckle tracking software. The amplitude of PSS (ε PSS ) and end-systolic strain (ε ES ) were measured and the difference of ε ES between a segment perfused by the LAD and the average of the other 5 segments was calculated (Δε ES ). Results: In the LAD segment, dyskinetic motion and PSS occurred during LAD occlusion but they were paradoxically attenuated during both LAD and LCx occlusion. ε PSS significantly correlated with Δε ES (r=0.95, p<0.05). Although ε PSS significantly decreased during both occlusion compared to LAD occlusion, ε PSS corrected by Δε ES (ε PSS /Δε ES ) did not decrease (figure). Conclusions: PSS in the ischemic myocardium was attenuated when the surrounding myocardium also became ischemic. The difference of contraction between the ischemic and the surrounding myocardium at end-systole seems to be a determinant of the amplitude of PSS. A parameter ε PSS /Δε ES may be useful for assessing ischemia in patients with multivessel disease.

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