AI Article Synopsis
Article Abstract
Aim: To investigate the impact of primary reperfusion therapy (RT) on early and late mortality in acute right ventricular infarction (RVI).
Methods: RVI patients (n = 679) were prospectively classified as without right ventricular failure (RVF) (class A, n = 425, 64%), with RVF (class B, n = 158, 24%) or with cardiogenic shock (CS) (class C, n = 96, 12%). Of the 679 patients, 148 (21.7%) were considered to be eligible for thrombolytic therapy (TT) and 351 (51.6%) for primary percutaneous coronary intervention (PPCI). TIMI 3-flow by TT was achieved for A, B and C RVI class in 65%, 64% and 0%, respectively and with PPCI in 93%, 91% and 87%, respectively.
Results: For class A without RT, the mortality rate was 7.9%, with TT was reduced to 4.4% (P < 0.01) and with PPCI to 3.2% (P < 0.01). Considering TT vs PPCI, PPCI was superior (P < 0.05). For class B without RT the mortality was 27%, decreased to 13% with TT (P < 0.01) and to 8.3% with PPCI (P < 0.01). In a TT and PPCI comparison, PPCI was superior (P < 0.01). For class C without RT the in-hospital mortality was 80%, with TT was 100% and with PPCI, the rate decreased to 44% (P < 0.01). At 8 years, the mortality rate without RT for class A was 32%, for class B was 48% and for class C was 85%. When PPCI was successful, the long-term mortality was lower than previously reported for the 3 RVI classes (A: 21%, B: 38%, C: 70%; P < 0.001).
Conclusion: PPCI is superior to TT and reduces short/long-term mortality for all RVI categories. RVI CS patients should be encouraged to undergo PPCI at a specialized center.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3920162 | PMC |
| http://dx.doi.org/10.4330/wjc.v6.i1.14 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Reduced adenosine receptor expression in ACS patients with no-flow phenomenon undergoing primary PCI.
Future Cardiol
December 2024
Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Introduction: Acute coronary syndrome (ACS) patients undergoing primary percutaneous coronary intervention (PPCI) often experience the no-reflow phenomenon (NRP), characterized by reduced myocardial perfusion despite an open coronary artery. Adenosine, a potent vasodilator, is used to aid reperfusion. To elucidate underlying molecular mechanism of this phenomenon, we investigated expression of ADORA2A and ADORA2B genes, encoding adenosine receptors, in ACS patients with NRP and non-NRP.
View Article and Find Full Text PDFPrognostic impact of coronary microvascular dysfunction in patients with myocardial infarction evaluated by new angiography-derived index of microvascular resistance.
Int J Cardiol Heart Vasc
February 2025
Department of Cardiology, University Hospital, 38000 Grenoble, France.
Background: Several methods for measuring IMR derived from angiography have been developed. AngioIMR is a novel method for the assessment of angiography-derived IMR with no requirement for a wire and hyperemia. The prognostic value of AngioIMR is unknown in STEMI patients.
View Article and Find Full Text PDFComprehensive analysis of the impact of primary percutaneous coronary intervention on patients with ST-segment elevation myocardial infarction.
World J Exp Med
December 2024
Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States.
This comprehensive analysis by Saeed and Faeq investigates the impact of primary percutaneous coronary intervention (pPCI) on mortality among patients with ST-segment elevation myocardial infarction (STEMI) at the Erbil Cardiac Center. Analyzing data from 96 consecutive STEMI patients, the study identified significant predictors of in-hospital mortality, emphasizing the critical impact of time of hospital arrival post-symptom onset on overall prognosis. Findings indicate that factors such as atypical presentation, cardiogenic shock, chronic kidney disease, and specific coronary complications are associated with higher mortality rates.
View Article and Find Full Text PDFSuccessful Rescue of Ventricular Fibrillation Electrical Storm Secondary to Acute Myocardial Infarction in a Patient Presenting to a District General Hospital: A Case Report.
Cureus
November 2024
Interventional Cardiology, Hull University Teaching Hospital National Health Service Trust, Hull, GBR.
Ventricular arrhythmia is a critical and challenging cardiovascular complication of myocardial infarction (MI). An electrical storm (ES), characterised by three or more episodes of sustained ventricular arrhythmia within 24 hours, poses a significant life-threatening risk. Standard management includes advanced life support (ALS) protocols and specialised pharmacological interventions.
View Article and Find Full Text PDFPrediction of major adverse cardiovascular events following acute myocardial infarction using electrocardiogram DETERMINE score.
BMC Cardiovasc Disord
December 2024
Department of Anesthesiology and Perioperative Medicine, Second Affiliated Hospital of Anhui Medical University, Hefei, China.
Background: Acute myocardial infarction (AMI) remains a major cause of mortality and morbidity globally, with a high incidence of major adverse cardiovascular events (MACE) post-primary percutaneous coronary intervention (PPCI). The DETERMINE score, derived from electrocardiographic (ECG) markers, has shown promise as a predictor of adverse outcomes, but its clinical utility requires further validation.
Objective: To evaluate the predictive value of the DETERMINE score for MACE and provide early clinical warnings for high-risk patients.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!