کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2837089 1164887 2011 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Association between ST segment Resolution following Fibrinolytic therapy or Intracoronary stenting, and Reinfarction in the same myocardial region in the DANAMI-2 study population
موضوعات مرتبط
علوم زیستی و بیوفناوری بیوشیمی، ژنتیک و زیست شناسی مولکولی پزشکی مولکولی
پیش نمایش صفحه اول مقاله
Association between ST segment Resolution following Fibrinolytic therapy or Intracoronary stenting, and Reinfarction in the same myocardial region in the DANAMI-2 study population
چکیده انگلیسی

BackgroundST-segment resolution has long been used as one of several clinical markers of response to reperfusion therapy. With the use of the DANish trial in Acute Myocardial Infarction-2 (DANAMI-2) database, this case–control study tests the hypothesis that incomplete ST-segment resolution (<70%) will be predictive of the risk of reinfarction in the same myocardial region regardless of the reperfusion therapy employed.Methods and resultsOne hundred forty-nine (9.5%) patients with clinical reinfarction were matched to patients with no documented reinfarction (“no reinfarction”). With the use of the initial DANAMI-2 and reinfarction electrocardiograms, 80 patients were found to have reinfarction in the same myocardial region (“reinfarction”). “Reinfarction” and their matched “no-reinfarction” patients were included (n=160), and prereperfusion and postreperfusion ST segments were measured manually.Of all “reinfarction” patients, 66% (53 of 80) had incomplete ST-segment resolution [P=.13; odds ratio (OR)=1.69]. Stratified by the reperfusion strategy employed, this corresponded to 67% (35 of 52) being treated with fibrinolytics (P=.45; OR=1.33), suggesting that these patients were equally likely to reinfarct in the same myocardial region regardless of the degree of ST-segment resolution. In the primary percutaneous coronary intervention (pPCI) arm, 64% (18 of 28) of patients with reinfarction in the same myocardial region had incomplete ST-segment resolution (P=.10; OR=6.0). In the pPCI arm, the trend was that patients with incomplete ST-segment resolution were more likely to reinfarct in the same myocardial region than those with complete ST-segment resolution, but these findings did not reach statistical significance. No statistically significant difference was found in the association of reinfarction in the same myocardial region and ST-segment resolution between the two treatment arms (P=.11).ConclusionThe results from this study suggest that, although fibrinolytic-treated patients are more likely to reinfarct in the same myocardial region than pPCI-treated patients, there is no clear statistically significant association between ST-segment resolution and reinfarction in the same myocardial region. Trends in the data suggest that fibrinolytic-treated patients are equally likely to reinfarct in the same myocardial region regardless of the degree of ST-segment resolution. However, the trend in the pPCI population is such that incomplete ST-segment resolution is associated with a higher likelihood of reinfarction in the same myocardial region.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Cardiovascular Revascularization Medicine - Volume 12, Issue 2, March–April 2011, Pages 75–81
نویسندگان
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