Late phase of repolarization (TpeakTend) as a prognostic marker of left ventricle remodeling in patients with anterior myocardial infarction treated with primary coronary intervention. (9/56)

BACKGROUND: Left ventricle remodeling (LVR) is regarded as a marker of unfavorable outcome in patients following acute myocardial infarction (AMI). Repolarization, especially its late part (TpeakTend), is strongly related to local myocardial attributes. We assessed prospectively in this study if repolarization duration (measured from one hour of nighttime) might predict LVR occurrence in patients with anterior AMI treated with primary percutaneous coronary intervention (PCI). METHODS: The study population consisted of 111 patients with first anterior AMI (82 males, age 58 +/- 11 years, LVEF 41 +/- 7%) treated with the primary PCI of left anterior descending coronary artery. LVR, defined as left ventricle end-diastolic volume increase by > 20% during six months follow-up, occurred in 35 patients (31 males, age 56 +/- 10 years, LVEF 37 +/- 7%, LVR+), while the other 76 subjects were free of LVR (51 males, age 58 +/- 10 years, LVEF 43 +/- 7%, LVR-). Holter recordings were performed in the fifth day of AMI. Repolarization parameters: QT, QTpeak and TpeakTend were assessed from one hour of nighttime Holter recording (between 1-4 a.m.). RESULTS: LVR occurred more frequently in males (p = 0.02). LVEF was lower in LVR+ patients (p = 0.001). QTc was similar: 441 +/- 29 ms vs 434 +/- 25 ms, p = 0.37 for LVR+ vs LVR-. Patients with LVR had shorter QTpeakc (333 +/- 34 ms vs 345 +/- 25 ms, p = 0.03) and remarkably longer TpeakTendc (108 +/- 15 ms vs 89 +/- 17 ms, p = 0.0001). Receiver operating characteristics analysis revealed that the best cut-off value for LVR prediction was 103 ms--sensitivity: 65.7%, specificity: 81.6%, positive predictive value: 62%, negative predictive value: 83.8%. CONCLUSIONS: The greater transmural heterogeneity of the repolarization processes described by TpeakTend interval measured at discharge after AMI seems to be a prognostic marker of left ventricle remodeling occurrence during six months follow-up in patients with acute anterior infarction.  (+info)

Contrast-induced nephropathy in postmenopausal women undergoing percutaneous coronary intervention for acute myocardial infarction. (10/56)

Contrast-induced nephropathy (CIN) is a complex syndrome of acute kidney injury induced by exposure to intravascular contrast media. CIN occurs frequently in patients undergoing urgent percutaneous coronary intervention (PCI) and is associated with poor outcomes, making it a major challenge faced by interventional cardiologists. It has been suggested that female sex is a risk factor for development of CIN following PCI. However, no data exist in the literature concerning the risks of postmenopausal women with acute myocardial infarction (AMI) developing CIN after undergoing urgent PCI. To explore the incidence, risk factors and in-hospital outcomes of CIN in this special population, we analyzed 69 postmenopausal women with AMI treated with urgent PCI. CIN was defined as a relative increase of >25% or an absolute increase of >or=0.5 mg/dL in serum creatinine concentration from the baseline value 72 h after exposure to contrast medium. We found 1) the incidence of CIN was 37.68%; 2) patients with CIN had worse in-hospital outcomes, including longer hospital stay and more in-hospital adverse events; and 3) in multivariate logistic analysis, independent risk factors for CIN included a longer menopausal duration and the implantation of an intra-aortic balloon pump (an indirect indicator of hemodynamic instability). These results indicate that CIN is a frequent complication associated with worse in-hospital outcomes in postmenopausal women with AMI who are undergoing urgent PCI, particularly those with longer menopausal duration and hemodynamic instability. It is therefore necessary to pay more attention to preventive strategies for renal protection in this special population.  (+info)

Genome-wide association study identifies a susceptibility locus at 21q21 for ventricular fibrillation in acute myocardial infarction. (11/56)

 (+info)

Prognostic value of lead V1 ST elevation during acute inferior myocardial infarction. (12/56)

 (+info)

Ventricular septal rupture after acute myocardial infarction. (13/56)

Ventricular septal rupture is a rare complication of acute myocardial infarction with important hemodynamic consequences. Spontaneous closure is extremely rare. Without a rapid diagnosis and correction by surgical intervention, the short-term mortality of these patients is higher than 90%. We report the case of a patient with acute myocardial infarction and a ventricular septal rupture that was partially closed by the formation of a thrombus. Early diagnosis was obtained in the emergency room, based on clinical examination and transthoracic echocardiography.  (+info)

Assessment of coronary artery flow velocity pattern as a long-term predictor of left ventricular function and cardiac events after percutaneous coronary intervention in anterior acute myocardial infarction. (14/56)

BACKGROUND: Coronary flow velocity (CFV) can be used to assess short-term left ventricular function recovery and the clinical prognosis of patients with acute myocardial infarction (AMI). We evaluated CFV as a predictor of long-term left ventricular function recovery and cardiac events in patients with anterior wall AMI. METHODS AND RESULTS: CFV pattern of the distal left anterior descending (LAD), wall motion score index (WMSI) and left ventricular ejection fraction (LVEF) were recorded at the points of time within 24 hours, 3 days, 6 months, and 3 years after percutaneous coronary intervention (PCI) in 50 consecutive patients with anterior wall AMI. The clinical data were collected. Patients were divided into two groups based on diastolic deceleration time (DDT) 3 days after PCI. Compared with 3 days, LVEF and WMSI in group A (DDT>600 ms, n=20) improved in 6 months and 3 years (p<0.01), but they were unchanged in group B (DDT< or =600 ms, n=30). The incidence of cardiac events was higher in group B than in group A during 6 months (p<0.01).With a 3-year follow up, the incidence of chronic heart failure was higher in group B than in group A (p=0.009). CONCLUSION: CFV could be used as a predictor of long-term left ventricular function recovery and cardiac events in patients with anterior wall AMI.  (+info)

Anticoagulation after anterior myocardial infarction and the risk of stroke. (15/56)

 (+info)

Effect of peri-infarct pacing early after myocardial infarction: results of the prevention of myocardial enlargement and dilatation post myocardial infarction study. (16/56)

 (+info)