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Late percutaneous coronary intervention for an occluded infarct-related artery in patients with preserved infarct zone viability: a pooled analysis of cardiovascular magnetic resonance studies.
- Source :
-
Cardiology journal [Cardiol J] 2013; Vol. 20 (5), pp. 552-9. - Publication Year :
- 2013
-
Abstract
- Background: The results of clinical trials assessing the effect of late opening of infarct-related artery (IRA) on left ventricular ejection fraction (LVEF) and size in stable patients are equivocal, which may be related to the fact that the presence of viability was not a requirement for randomization in these trials. The aim of the study was to assess the influence of late percutaneous coronary intervention (PCI) with optimal medical therapy (OMT) vs. OMT alone on cardiac function and remodeling in patients presenting infarct zone with preserved viability on cardiovascular magnetic resonance (CMR).<br />Methods: The analysis included pooled data of 43 patients from 3 randomized studies. All patients underwent CMR before randomization, but only in 1 previously unpublished study was preserved viability required for randomization to treatment. Follow-up CMR was performed after 6-12 months.<br />Results: Late PCI with OMT led to improved LVEF (+5 ± 7% vs. -1 ± 6%, p = 0.005), decreased left ventricular end-systolic volume (-11 ± 19 mL vs. 12 ± 40 mL, p = 0.02) and a trend towards a decrease in end-diastolic volume (-7 ± 27 mL vs. 15 ± 47 mL, p = 0.07) in comparison to OMT alone. Increased LVEF and decreased left ventricular volumes were observed after the analysis was restricted to patients with left anterior descending artery (LAD) occlusion.<br />Conclusions: In patients with the presence of infarct zone viability, OMT with late PCI for an occluded IRA (particularly LAD) is associated with improvement of left ventricular systolic function and size over OMT alone.
- Subjects :
- Coronary Occlusion complications
Coronary Occlusion pathology
Coronary Occlusion physiopathology
Humans
Myocardial Infarction etiology
Myocardial Infarction pathology
Myocardial Infarction physiopathology
Predictive Value of Tests
Randomized Controlled Trials as Topic
Recovery of Function
Stroke Volume
Time Factors
Tissue Survival
Treatment Outcome
Ventricular Function, Left
Ventricular Remodeling
Coronary Occlusion therapy
Magnetic Resonance Imaging
Myocardial Infarction therapy
Myocardium pathology
Percutaneous Coronary Intervention
Subjects
Details
- Language :
- English
- ISSN :
- 1898-018X
- Volume :
- 20
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Cardiology journal
- Publication Type :
- Academic Journal
- Accession number :
- 24297771
- Full Text :
- https://doi.org/10.5603/CJ.2013.0141