Relationship of left ventricular end-diastolic pressure with extent of myocardial ischemia, myocardial salvage and long-term outcome in patients with ST-segment elevation myocardial infarction.

Ndrepepa, Gjin; Cassese, Salvatore; Hashorva, Desard; Kufner, Sebastian; Xhepa, Erion; Hasimi, Endri; Fusaro, Massimiliano; Laugwitz, Karl-Ludwig; Schunkert, Heribert; Kastrati, Adnan

doi:10.1002/ccd.28098

2019

Back
Back to start of result list
Permanent link for displayed object

Document type:: Article; Journal Article
Author(s):: Ndrepepa, Gjin; Cassese, Salvatore; Hashorva, Desard; Kufner, Sebastian; Xhepa, Erion; Hasimi, Endri; Fusaro, Massimiliano; Laugwitz, Karl-Ludwig; Schunkert, Heribert; Kastrati, Adnan
Title:: Relationship of left ventricular end-diastolic pressure with extent of myocardial ischemia, myocardial salvage and long-term outcome in patients with ST-segment elevation myocardial infarction.
Abstract:: OBJECTIVES: We aimed to assess the association of left ventricular end-diastolic pressure (LVEDP) with myocardial salvage and long-term mortality in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). BACKGROUND: The association of LVEDP with myocardial salvage or long-term mortality in patients with STEMI has not been investigated. METHODS: This study included 1,312 patients with STEMI undergoing primary PCI between 2002 and 2007. LVEDP was measured at the time of intervention. Patients were divided into three groups: a group with LVEDP in the 1st tertile (LVEDP, 4-19 mmHg; n = 496), a group with LVEDP in the 2nd tertile (LVEDP >19-24 mmHg; n = 410) and a group with LVEDP in the 3rd tertile (LVEDP >24-45 mmHg; n = 406). The primary outcome was 8-year cardiac mortality. RESULTS: The primary outcome (cardiac deaths) occurred in 114 patients. Deaths occurred in 26 (7.9%), 36 (11.5%), and 52 (16.4%) patients with LVEDP in the 1st to 3rd tertiles, respectively (adjusted hazard ratio = 1.18, 95% confidence interval 1.02-1.36, P = 0.022, for 5 mmHg increment in the LVEDP values). LVEDP correlated with the extent of myocardial ischemia (R = 0.351; P < 0.001). In patients with LVEDP in the 1st to 3rd tertiles, the salvage index (proportion of initial area at risk salvaged) was 0.53 [0.27-0.84], 0.53 [0.28-0.80], and 0.43 [0.18-0.75], respectively (P = 0.012). After adjustment, LVEDP correlated inversely with myocardial salvage (P < 0.001). CONCLUSIONS: In patients with STEMI, elevated LVEDP correlated with the extent of myocardial ischemia, reduced myocardial salvage and increased risk of 8-year cardiac mortality.
Journal title abbreviation:: Catheter Cardiovasc Interv
Year:: 2019
Journal volume:: 93
Journal issue:: 5
Pages contribution:: 901-909
Fulltext / DOI:: doi:10.1002/ccd.28098
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/30680881
Print-ISSN:: 1522-1946
TUM Institution:: I. Medizinische Klinik und Poliklinik (Kardiologie); Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (Prof. Schunkert)
BibTeX

Occurrences:

mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik und Poliklinik für Innere Medizin I, Kardiologie (Prof. Laugwitz)2019

mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Lehr- und Forschungskooperationen mit den Kliniken und Instituten am Deutschen Herzzentrum Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (DHM) (Prof. Schunkert)2019