Abstract:
BACKGROUND:There is increasing evidence that an open infarct-related artery results in increased electrical stability of the heart and that this effect is at least in part responsible for the favorable outcome of these patients. In the thrombolytic era the optimal strategy for risk stratification remains controversial. This study examined the predictors of serious arrhythmic events during the first year after myocardial infarction. METHODS:A total of 222 patients with acute myocardial infarction, 41.4% of whom were treated with thrombolysis, were studied. At hospital discharge, signal-averaged electrocardiography was performed on 196 subjects and Holter monitoring on 200. One hundred and ninety-seven patients underwent coronary angiography. Left ventricular ejection fraction was determined in 201 subjects. RESULTS:An open infarct-related artery was documented in 106 patients. The incidence of late potentials was 34% (66 patients). Twenty-four patients (10.8%) had an arrhythmic event during follow-up (sudden death in seven, sustained ventricular tachyarrhythmias in 15, unexplained syncope in two). Signal-averaged electrocardiography had a sensitivity of 94% and a specificity of 72% for prediction of arrhythmic events. An occluded infarct-related artery was 78% sensitive and 58% specific, a left ventricular ejection fraction below 40% had a sensitivity of 71% and specificity of 80%, and Holter monitoring was only 38% sensitive and 92% specific. A combination of late potentials plus an occluded infarct-related artery was 68% sensitive and 84% specific. Positive predictive value was low for all variables examined, but could be improved by the combination of several risk factors. The highest positive predictive value was provided by the combination of an abnormal signal-averaged ECG and complex ventricular arrhythmias on ambulatory ECG. On multivariate analysis, in rank order, presence of late potentials, ejection fraction below 40%, high-grade ventricular ectopic activity and an occluded infarct-related artery were predictive of arrhythmic events. CONCLUSION:Among patients surviving an acute myocardial infarction, the occurrence of malignant arrhythmic events can be reliably predicted by the combination of an abnormal signal-averaged ECG, left ventricular dysfunction, complex ventricular arrhythmias on Holter monitoring and an occluded infarct-related artery at the time of hospital discharge.
journal_name
Coron Artery Disjournal_title
Coronary artery diseaseauthors
Hermosillo AG,Araya V,Casanova JMsubject
Has Abstractpub_date
1995-12-01 00:00:00pages
973-83issue
12eissn
0954-6928issn
1473-5830journal_volume
6pub_type
杂志文章abstract::Cardiovascular magnetic resonance of anomalous coronary arteries is a class I indication. The term anomalous coronary artery encompasses those with an abnormal origin (from the incorrect sinus, too-high or too-low from the correct sinus, or from the pulmonary artery) and/or number of ostia. Their clinical significance...
journal_title:Coronary artery disease
pub_type: 杂志文章,评审
doi:10.1097/00019501-200509000-00004
更新日期:2005-09-01 00:00:00
abstract::The use of antiplatelet agents in the management of patients undergoing percutaneous coronary interventions involves the administration of aspirin, thienopyridines, and in high-risk patients, GPIIb-IIIa antagonists. Drug-eluting stents now account for greater than 50% of stenting procedures. This review focuses on the...
journal_title:Coronary artery disease
pub_type: 杂志文章,评审
doi:10.1097/00019501-200409000-00005
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND:We report on 10 patients with Kawasaki disease and thrombocytopenia who were found to have a high incidence of coronary artery aneurysm and acute myocardial infarction. The clinical features of these patients, the cause of their thrombocytopenia and the relationship between cardiovascular pathology and throm...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:
更新日期:1995-11-01 00:00:00
abstract:OBJECTIVE:Erectile dysfunction and coronary artery disease share similar risk factors. Although phosphodiesterase-5 inhibitors used to treat erectile dysfunction do not adversely affect hemodynamic parameters in patients with coronary artery disease, their effects on myocardial blood flow are unknown. METHODS:In a ran...
journal_title:Coronary artery disease
pub_type: 杂志文章,随机对照试验
doi:10.1097/00019501-200609000-00001
更新日期:2006-09-01 00:00:00
abstract::Potentially hazardous short ischemic episodes increase the tolerance of myocardium to ischemia paradoxically. This condition decreases the infarct area markedly caused by a longer duration of coronary occlusion. This phenomenon is known as 'ischemic preconditioning' and its powerful cardioprotective effect has been sh...
journal_title:Coronary artery disease
pub_type: 杂志文章,评审
doi:10.1097/00019501-200605000-00013
更新日期:2006-05-01 00:00:00
abstract:OBJECTIVES:We treated patients experiencing drug-eluting stent (DES) restenosis with plain old balloon angioplasty (POBA), implantation of the same type of DES [homogeneous drug-eluting stent (HOMO-DES)], or implantation of a different type of DES [heterogeneous drug-eluting stent (HETERO-DES)], and compared the effica...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/MCA.0000000000000159
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVES:Red cell distribution width (RDW), a measure of red blood cell size heterogeneity, was evaluated in patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). BACKGROUND:Higher RDW is associated with mortality in patients with symptomatic car...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/MCA.0b013e328342c77b
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVE:Drug-coated balloon (DCB) angioplasty has emerged as an effective management strategy worldwide. In June 2016, DCB became available for the treatment of de novo small coronary lesions in Japan; however, there has been no multicenter analysis in a post-approval real-world clinical setting to date. The aim of t...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/MCA.0000000000000782
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Percutaneous coronary intervention-induced myocardial infarction (PMI) has prognostic significance. Identifying patients at high risk for PMI is desirable as it may alter strategy and facilitate early preventative therapy. We therefore sought to establish whether preprocedural demographic, interventional (pl...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/MCA.0000000000000582
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:For patients with severe ischemic heart disease, complete revascularization by a percutaneous coronary intervention or coronary artery bypass grafting is often not achieved and may still cause residual angina. In case of progressive coronary artery occlusions, therapeutic arteriogenesis constitutes a promisi...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/MCA.0000000000000569
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:The 2015 American College of Cardiology/American Heart Association update on primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) recommended PCI of the non-infarct-related artery at the time of primary PCI (class IIb recommendation). Despite ev...
journal_title:Coronary artery disease
pub_type: 杂志文章,meta分析
doi:10.1097/MCA.0000000000000578
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:T-cell-mediated immune responses play important roles in the progression of atherosclerotic disease. Studies have linked various inflammatory biomarkers with the burden of coronary artery calcification, but the significance of T-cell-specific chemokines in coronary artery calcification has not been confirmed...
journal_title:Coronary artery disease
pub_type: 临床试验,杂志文章
doi:10.1097/MCA.0000000000000236
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:Adiponectin and resistin, which have counteracting effects, are suggested to be associated with inflammation and atherosclerosis. The relationship between their levels and prognosis in high risk patients is, however, still unclear. The aim of this study was to evaluate the prognostic values of these adipokin...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/MCA.0b013e328318ecb0
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Bifurcation lesions represent a distinct lesion subset associated with an increased risk of procedural complications. Data on the incidence, treatment, and outcome of bifurcation lesions associated with chronic total occlusions are limited. METHODS:Among chronic total occlusion procedures performed by a sin...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/MCA.0000000000000194
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVES:This Perspective reviews the results of early and contemporary studies evaluating the safety and efficacy of coronary revascularization in patients with diabetes. It also addresses the implications of some of the data in the Bypass Angioplasty Revascularization Investigation in type 2 diabetes (BARI 2D) tria...
journal_title:Coronary artery disease
pub_type: 杂志文章,评审
doi:10.1097/MCA.0b013e3283383ebe
更新日期:2010-05-01 00:00:00
abstract:BACKGROUND:We have previously identified a phenomenon that we called vascular rhexis (VR) after coronary occlusion in mice. To explore its potential pathogenetic impact on the destruction of vessels described, its potential universality, and its characterization as a scaffolding for evaluating amelioration, we studied ...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/MCA.0b013e32835d6688
更新日期:2013-05-01 00:00:00
abstract:OBJECTIVE:Atrial fibrillation is one of the most common arrhythmias associated with not only increased morbidity after coronary artery bypass grafting but also increased healthcare costs. Many factors are associated with atrial fibrillation onset after coronary artery bypass grafting. We prospectively examined which fa...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/MCA.0b013e3281689a2c
更新日期:2007-08-01 00:00:00
abstract:BACKGROUND:Cytomegalovirus (CMV), Chlamydia pneumoniae (C. pneumoniae), and Helicobacter pylori (H. pylori) have been implicated in atherosclerosis and restenosis after angioplasty. The patterns of distribution within coronary lesions and possible coinfections of these pathogens in the coronary vasculature had not prev...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/00019501-200102000-00001
更新日期:2001-02-01 00:00:00
abstract:BACKGROUND:The plasma level of homocysteine is an independent risk factor for atherosclerotic vascular disease. The relationship between plasma homocysteine level and the onset of coronary artery disease (CAD) has not been established. OBJECTIVE:To investigate the relationship between plasma homocysteine level and the...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/00019501-199910000-00002
更新日期:1999-10-01 00:00:00
abstract:BACKGROUND:To assess the incidence, clinical significance, and independent risk factors of stroke in patients with acute myocardial infarction (AMI) treated invasively. MATERIALS AND METHODS:We analyzed 2520 consecutive patients with AMI admitted between 2003 and 2007. Data on long-term follow-up were screened to iden...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/MCA.0b013e32834df573
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Elderly patients with ischaemic heart disease are often treated more conservatively and for longer than younger patients, but this strategy may result in subsequent invasive intervention of more advanced and higher risk coronary disease. METHODS:We performed a retrospective analysis of 109 patients aged > o...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/00019501-199711000-00006
更新日期:1997-11-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to assess the association of widowhood with the severity and extent of coronary artery disease (CAD), and whether it is modified by sex or socioeconomic status. PATIENTS AND METHODS:A total of 1068 patients undergoing coronary angiography at five centers in Saudi Arabia and the Uni...
journal_title:Coronary artery disease
pub_type: 杂志文章,多中心研究
doi:10.1097/MCA.0000000000000436
更新日期:2017-03-01 00:00:00
abstract:AIMS:Uric acid (UA) has been associated with the presence and severity of coronary artery disease. To further assess the role of UA role in coronary artery disease, we investigated UA levels in both healthy asymptomatic middle-aged individuals and in different subgroups of hospitalized patients with suspected or defini...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/MCA.0000000000000593
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Coronary heart disease is mainly caused by the effects of obstruction to blood flow in the coronary arteries from discrete mural lesions that encroach into the lumen and usually occur in arteries that are involved by atherosclerosis. Even though the level of certain lipoproteins is indisputably related to th...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/00019501-199303000-00006
更新日期:1993-03-01 00:00:00
abstract:BACKGROUND:Different cardiovascular risk calculators and risk-based thresholds for initiating statin therapy are currently in use. Using coronary computed tomography angiography, we sought to compare the Pooled-Cohort Equation [atherosclerotic cardiovascular disease (ASCVD) score] with the Systematic COronary Risk Eval...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/MCA.0000000000000398
更新日期:2016-11-01 00:00:00
abstract:OBJECTIVE:To report the final, cumulative, 5-year outcomes from the TAXUS ATLAS program, which studied the use of the TAXUS Liberté paclitaxel-eluting stent in de-novo coronary artery lesions. METHODS:TAXUS ATLAS Workhorse, Small Vessel, and Long Lesion are nonrandomized studies comparing TAXUS Liberté (N=871), TAXUS ...
journal_title:Coronary artery disease
pub_type: 杂志文章,多中心研究
doi:10.1097/MCA.0b013e32835b3932
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:There are few reports regarding the concordance of coronary arterial response between acetylcholine (ACh) and ergonovine (ER) spasm provocation tests. OBJECTIVES:We attempted to perform selective spasm provocation tests to examine the incidence of provoked spasm in patients who had undergone first coronary ...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/00019501-200412000-00006
更新日期:2004-12-01 00:00:00
abstract:BACKGROUND:Previous studies have suggested an increased risk of myocardial infarction associated with physical exercise. Activated neutrophils may contribute to the triggering mechanisms. METHODS:Fifteen patients with stable angina pectoris underwent symptom-limited bicycle ergometry. In neutrophils obtained from seri...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:
更新日期:1995-07-01 00:00:00
abstract:BACKGROUND:Low-molecular-weight heparins may have a higher benefit to risk ratio than unfractionated heparin in preventing perioperative thrombosis. The antithrombotic effects of low-molecular-weight heparins, given as adjunctive therapy to alteplase and aspirin, have not previously been compared with those of unfracti...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:
更新日期:1995-03-01 00:00:00
abstract:BACKGROUND:We have demonstrated previously that, when repeated reperfusion is performed after reocclusion, there is a decrease in the amount of myocardial salvage, despite early reperfusion. Treatment with nisoldipine induced a beneficial effect by reduction of infarct size in this experimental model. OBJECTIVE:To stu...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/00019501-200003000-00013
更新日期:2000-03-01 00:00:00