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Association Between Early Q Waves and Reperfusion Success in Patients With ST-Segment-Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention: A Cardiac Magnetic Resonance Imaging Study
- Source :
- Topal, D G, Lønborg, J, Ahtarovski, K A, Nepper-Christensen, L, Helqvist, S, Holmvang, L, Pedersen, F, Clemmensen, P, Saünamaki, K, Jørgensen, E, Kyhl, K, Ghotbi, A, Schoos, M M, Göransson, C, Bertelsen, L, Høfsten, D, Køber, L, Kelbæk, H, Vejlstrup, N & Engstrøm, T 2017, ' Association Between Early Q Waves and Reperfusion Success in Patients With ST-Segment-Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention : A Cardiac Magnetic Resonance Imaging Study ', Circulation: Cardiovascular Interventions, vol. 10, no. 3, e004467 . https://doi.org/10.1161/CIRCINTERVENTIONS.116.004467
- Publication Year :
- 2016
-
Abstract
- Background— Pathological early Q waves (QW) are associated with adverse outcomes in patients with ST-segment–elevation myocardial infarction (STEMI). Primary percutaneous coronary intervention (PCI) may therefore be less beneficial in patients with QW than in patients without QW. Myocardial salvage index and microvascular obstruction (MVO) are markers for reperfusion success. Thus, to clarify the benefit from primary PCI in STEMI patients with QW, we examined the association between baseline QW and myocardial salvage index and MVO in STEMI patients treated with primary PCI. Methods and Results— The ECG was assessed before primary PCI for the presence of QW (early) in 515 STEMI patients. The patients underwent a cardiac magnetic resonance imaging scan at day 1 (interquartile range [IQR], 1–1) and again at day 92 (IQR, 89–96). Early QW was observed in 108 (21%) patients and was related to smaller final myocardial salvage index (0.59 [IQR, 0.39–0.69] versus 0.65 [IQR, 0.46–0.84]; P P P =0.03) and MVO (β=0.18; P =0.001) after adjusting for potential confounders. Conclusions— Patients presenting with their first STEMI and early QW in the ECG had smaller myocardial salvage index and more extensive MVO than non-QW despite treatment within 12 hours after symptom onset. However, final myocardial salvage index in patients with QW was substantial, and patients with QW still benefit from primary PCI. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT01435408.
- Subjects :
- Male
medicine.medical_specialty
ST Elevation Myocardial Infarction/diagnosis
Time Factors
medicine.medical_treatment
infarction
Infarction
Action Potentials
030204 cardiovascular system & hematology
Heart Conduction System/physiopathology
03 medical and health sciences
Electrocardiography
0302 clinical medicine
Percutaneous Coronary Intervention
Interquartile range
Cardiac magnetic resonance imaging
Heart Conduction System
Heart Rate
Predictive Value of Tests
Risk Factors
Internal medicine
myocardium
medicine
ST segment
Humans
cardiovascular diseases
030212 general & internal medicine
Myocardial infarction
catheterization
Percutaneous Coronary Intervention/adverse effects
Aged
medicine.diagnostic_test
business.industry
Patient Selection
Percutaneous coronary intervention
Middle Aged
medicine.disease
Magnetic Resonance Imaging
reperfusion
Treatment Outcome
Conventional PCI
Cardiology
ST Elevation Myocardial Infarction
Female
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 19417632
- Volume :
- 10
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Circulation. Cardiovascular interventions
- Accession number :
- edsair.doi.dedup.....562ecac9a59dced10b8b90d098a5386a