TY - JOUR
T1 - Impaired Myocardial Perfusion Is a Major Explanation of the Poor Outcome Observed in Patients Undergoing Primary Angioplasty for ST-Segment-Elevation Myocardial Infarction and Signs of Heart Failure
AU - De Luca, Giuseppe
AU - Van't Hof, Arnoud W.J.
AU - De Boer, Menko Jan
AU - Hoorntje, Jan C.A.
AU - Gosselink, A. T.Marcel
AU - Dambrink, Jan Henk E.
AU - Ottervanger, Jan Paul
AU - Zijlstra, Felix
AU - Suryapranata, Harry
PY - 2004/3/2
Y1 - 2004/3/2
N2 - Background - The aim of the present study was to investigate the prognostic implication of myocardial perfusion in patients with ST-segment-elevation myocardial infarction (STEMI) and signs of heart failure, treated with primary angioplasty. Methods and Results - Our population is represented by 1548 consecutive patients undergoing primary angioplasty for STEMI. Congestive heart failure was defined as Killip class > 1 at admission. Killip class was linearly associated with myocardial perfusion, enzymatic infarct size, predischarge ejection fraction, and 1-year mortality rate. Myocardial blush was an independent predictor of 1-year mortality (RR [95% CI]=2.92 [1.37 to 6.23], P=0.005) in patients with advanced Killip class at presentation. Conclusions - Our study shows that patients with heart failure complicating STEMI have impaired myocardial perfusion, which accounts for the poor outcome observed in these patients. Further efforts should be aimed at improving myocardial perfusion, beyond epicardial recanalization, to further improve the outcome of these high-risk patients.
AB - Background - The aim of the present study was to investigate the prognostic implication of myocardial perfusion in patients with ST-segment-elevation myocardial infarction (STEMI) and signs of heart failure, treated with primary angioplasty. Methods and Results - Our population is represented by 1548 consecutive patients undergoing primary angioplasty for STEMI. Congestive heart failure was defined as Killip class > 1 at admission. Killip class was linearly associated with myocardial perfusion, enzymatic infarct size, predischarge ejection fraction, and 1-year mortality rate. Myocardial blush was an independent predictor of 1-year mortality (RR [95% CI]=2.92 [1.37 to 6.23], P=0.005) in patients with advanced Killip class at presentation. Conclusions - Our study shows that patients with heart failure complicating STEMI have impaired myocardial perfusion, which accounts for the poor outcome observed in these patients. Further efforts should be aimed at improving myocardial perfusion, beyond epicardial recanalization, to further improve the outcome of these high-risk patients.
KW - Angioplasty
KW - Heart failure
KW - Perfusion
UR - http://www.scopus.com/inward/record.url?scp=1442311386&partnerID=8YFLogxK
U2 - 10.1161/01.CIR.0000120504.31457.28
DO - 10.1161/01.CIR.0000120504.31457.28
M3 - Article
SN - 0009-7322
VL - 109
SP - 958
EP - 961
JO - Circulation
JF - Circulation
IS - 8
ER -