2001-07-11
Predictors of left ventricular function after acute myocardial infarction: Effects of time to treatment, patency, and body mass index
Publication
Publication
The GUSTO-I angiographic experience
American Heart Journal , Volume 142 - Issue 1 p. 43- 50
Background Despite the significant survival benefit associated with successful reperfusion therapy for acute myocardial
infarction, global indices of outcome left ventricular function, such as ejection fraction, have often demonstrated little or
no improvement. Although these measurements are confounded by numerous clinical, physiologic, and angiographic variables,
no comprehensive analysis of this issue in a large series of patients is available. We used the Global Utilization of
Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (GUSTO-I) database to better understand
this phenomenon by determining independent predictors of left ventricular function and their interplay with regard to outcome
ventricular function and improvement in function during the initial postinfarction week.
Methods Ninety-minute and 5- to 7-day posttreatment global and regional indices derived from left ventriculograms
were analyzed from a population of 676 patients. These observations were combined with clinical data to describe independent
determinants of ventricular function outcome.
Results Clinical factors predictive of global and regional ventricular function as well as improvement in function between
90 minutes and 5 to 7 days included time to treatment, early infarct-related artery flow grade, and body mass index. These
same factors contribute significantly to compensatory hyperkinesis of the noninfarct zone, which is critical to maintenance of
global ventricular function during this time period.
Conclusions The ventricular function benefits of early complete reperfusion after myocardial infarction are readily
demonstrable after adjustment for multiple covariables and include (1) maintenance of global ventricular function and (2)
prevention or delay in ventricular dilatation. (Am Heart J 2001;142:43-50.)
Additional Metadata | |
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doi.org/10.1067/mhj.2001.116076, hdl.handle.net/1765/57882 | |
American Heart Journal | |
Organisation | Department of Cardiology |
Lundergan, C., Ross, A., McCarthy, W., Reiner, J., Boyle, D., Fink, C., … Coyne, K. S. (2001). Predictors of left ventricular function after acute myocardial infarction: Effects of time to treatment, patency, and body mass index. American Heart Journal, 142(1), 43–50. doi:10.1067/mhj.2001.116076 |