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Incidence, predictors, and prognostic value of intramyocardial hemorrhage lesions in ST elevation myocardial infarction
Catheterization and cardiovascular interventions, 2012-06, Vol.79 (7), p.1101-1108
Amabile, Nicolas
Jacquier, Alexis
Shuhab, Anes
Gaudart, Jean
Bartoli, Jean-Michel
Paganelli, Franck
Moulin, Guy
2012
Details
Autor(en) / Beteiligte
Amabile, Nicolas
Jacquier, Alexis
Shuhab, Anes
Gaudart, Jean
Bartoli, Jean-Michel
Paganelli, Franck
Moulin, Guy
Titel
Incidence, predictors, and prognostic value of intramyocardial hemorrhage lesions in ST elevation myocardial infarction
Ist Teil von
Catheterization and cardiovascular interventions, 2012-06, Vol.79 (7), p.1101-1108
Ort / Verlag
Hoboken: Wiley Subscription Services, Inc., A Wiley Company
Erscheinungsjahr
2012
Link zum Volltext
Quelle
MEDLINE
Beschreibungen/Notizen
Background: Intra myocardial hemorrhage lesions (IMH) are underdiagnosed complication of ST elevation myocardial infarction (STEMI). We sought to determine the incidence, predictors and the prognostic value of IMH in STEMI using cardiac MR imaging (CMR) techniques. Methods: We screened for inclusion consecutive patients with STEMI treated by percutaneous coronary intervention (PCI) within the first 12 hr of evolution. IMH lesions were identified on T2‐weighted sequences on CMR between days 4 and 8 after PCI. Adverse cardiac events were defined as a composite of death + severe ventricular arrhythmias + acute coronary syndrome + acute heart failure. Results: N = 114 patients were included and n = 11 patients (10%) presented IMH lesions. Patients with IMH lesions had a larger myocardial infarction extent (25.6 ± 1.8 vs. 13.5 ± 1.0 % LV mass, P < 0.01), microvascular obstructive lesions extent (4.6 ± 1.0 vs. 1.3 ± 0.3% LV mass, P < 0.01) and lower LV ejection fraction (40.7 ± 2.3% vs. 50.7 ± 1.3%, P < 0.01). The value of glycemia at admission was an independent predictor of IMH development (Odd ratio 1.8 [1.1–2.8] per mmol l−1, P = 0.01). The incidence of adverse cardiac events was higher in the IMH group than in the non‐IMH group during the first year following STEMI (P = 0.01, log‐rank analysis). Cox regression analysis identified the presence of IMH lesions as an independent predictor of adverse clinical outcome (Hazard Ratio = 2.8 [1.2–6.8], P = 0.02). Conclusion: Our study indicates that IMH is a rare but severe finding in STEMI, associated with a larger myocardial infarction and a worse clinical outcome. Per‐PCI glycemia might influence IMH development. © 2011 Wiley Periodicals, Inc.
Sprache
Englisch
Identifikatoren
ISSN: 1522-1946
eISSN: 1522-726X
DOI: 10.1002/ccd.23278
Titel-ID: cdi_proquest_miscellaneous_1019614321
Format
–
Schlagworte
Aged
,
Angioplasty, Balloon, Coronary - adverse effects
,
Angioplasty, Balloon, Coronary - mortality
,
Cardiovascular Diseases - mortality
,
Chi-Square Distribution
,
Female
,
France
,
Hemorrhage - diagnosis
,
Hemorrhage - mortality
,
Hemorrhage - pathology
,
Humans
,
Hyperglycemia - mortality
,
Incidence
,
intra myocardial hemorrhage
,
Kaplan-Meier Estimate
,
Logistic Models
,
magnetic resonance imaging
,
Magnetic Resonance Imaging, Cine
,
Male
,
microcirculation
,
Middle Aged
,
Multivariate Analysis
,
myocardial infarction
,
Myocardial Infarction - diagnosis
,
Myocardial Infarction - mortality
,
Myocardial Infarction - pathology
,
Myocardial Infarction - therapy
,
Myocardium - pathology
,
Odds Ratio
,
Predictive Value of Tests
,
Proportional Hazards Models
,
Risk Assessment
,
Risk Factors
,
Time Factors
,
Treatment Outcome
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