Prognostic value of clinical markers of reperfusion in patients with acute myocardial infarction treated by thrombolytic therapy

Iparraguirre, Horacio Pomés; Conti, Carlos; Grancelli, Hugo; Ohman, E. Magnus; Calandrelli, Matías; Volman, Sergio; Garber, Victor

doi:10.1016/s0002-8703(97)70045-0

Cited by 7 publications

(6 citation statements)

References 28 publications

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“…Thus, occurrence of heart failure was significantly more in the SCR (-) group as compared to SCR (+) group (p < 0.05). Equal or higher occurrence of postinfarction angina and recurrence of MI in the group with SCR are comparable with the group without it in the present study as well as in the studies by Ipparaguirre et al, 6 Matetzky et al, 21 Simoons et al, 22 The GUSTO investigators, 23 and Barsottia. 14 In the present study, the overall mortality was 7 (8.75%), out of which 1 (1.25%) patient in the SCR (+) group, while 6 (7.5%) patients in the SCR (-) group.…”

Section: Discussionsupporting

confidence: 89%

“…There was significant difference in these two groups in terms of occurrence of Killip's class II or more (p = 0.02 S). Ipparaguirre et al 6 reported 90.8% of their patients in Killip's class I at the time of admission. Cardiac failure at admission was present in 9.2% of patients with 5.2% of patients from SCR (+) group and 16.2% patients from SCR (-) group (p < 0.001).…”

Section: Discussionmentioning

confidence: 95%

“…5 Reduction in chest pain after thrombolysis has been shown to correlate with angiographically assessed patency and can be used as clinical marker of reperfusion. 6 ST resolution after AMI is influenced by coronary artery status and achievement of early ST resolution is marker of reperfusion. 7,8 Washout of creatine kinase MB (CK-MB), i.e., released from injured myocytes occurs after restoration of coronary artery patency.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Markers of Reperfusion in Patients with Acute Myocardial Infarction and Its Prognostic Significance

Varma

Chillawar

Kamble

et al. 2016

IJRSMS

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

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Clinical Markers of Reperfusion in Patients with Acute Myocardial Infarction and Its Prognostic Significance

Varma

Chillawar

Kamble

et al. 2016

IJRSMS

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“…Currently, there is not enough data on the utility and importance of PTD for the follow‐up of patients with acute MI. Several large and small‐scale studies have pointed to the prognostic significance of noninvasive reperfusion criteria (NRC) after acute MI 8–13 …”

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confidence: 99%

Relationship Between Noninvasive Reperfusion Criteria and Pulsed‐Wave Tissue Doppler Parameters in Patients With Acute Myocardial Infarction Receiving Thrombolytic Therapy

et al. 2003

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Several studies have proven that noninvasive reperfusion criteria (NRC) have prognostic significance in patients receiving thrombolytic therapy (TT) after acute myocardial infarction (acute MI). In this study, we investigated the relationship between NRC and pulsed tissue Doppler (PTD) parameters in patients receiving TT after acute MI, and the role of PTD in the management and follow-up of patients with acute MI. The study group(n= 41)was divided into four subgroups defined as: anterior and posterior MI, with or without NRC. In the first PTD measurements (2-3 days after acute MI), all acute MI patients had significantly smaller peak systolic (S-wave) velocity in all evaluated segments and longer Q-Speak durations (time elapsed from the inscription of the Q-wave on the surface ECG to the peak of the S-wave in PTD) as compared with control patients(n= 22; P < 0.001 for both). Among the diastolic parameters, the E/A ratio was significantly smaller in the study group compared with the control group(P < 0.001). Among the patients who had received TT in the first 2 hours, those patients who had NRC displayed significantly higher peak S-wave values in all evaluated segments than those without NRC(P < 0.05). The second PTD study (4-5 weeks after acute MI), revealed that the difference between the systolic PTD parameters of the noninfarcted regions of the study and control groups disappeared. Infarct-related segments, however, displayed significant improvement only in patients having NRC. There was a significant positive correlation between the mean mitral annular S-wave velocity and left ventricular ejection fraction(r = 0.59, P < 0.001). In conclusion, a significant relationship was observed between the PTD parameters and the NRC, which are known to have prognostic significance.

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“…To guide such a second line invasive therapeutic strategy, reliable and fast clinical markers of thrombolytic success are needed. Among the non-invasive markers investigated for this purpose are ST-segment changes [1, 5, 8-18, 23, 24], resotution of chest pain [7] (overview in [11]), and evolution of enzymes (overview in [11]) [19]. In this context, complete ST-segment resolution seems to correlate even better with prognosis than invasive parameters like TIMI 3 Grade patency [25].…”

mentioning

confidence: 99%

Resolution of ST-segment elevation in acute myocardial infarction — Early prognostic significance after thrombolytic therapy

Carlsson

Kamp

Härtel

et al. 1999

Herz

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In acute myocardial infarction, early identification of patients at a high mortality risk is important for planning further therapeutic strategies. Previous studies have demonstrated that the extent of early resolution of ST-segment elevation may represent a simple, quick and noninvasive assessment to identify high risk groups of patients. In a subgroup of the COBALT Study population (Continuous Infusion vs Double Bolus Administration of Alteplase), ST-segment elevation was measured before and 90 to 120 minutes after treatment with alteplase. The subgroup of n = 1,760 patients was not different from the total COBALT population of n = 7169 patients regarding most clinical parameters except Killip Class before treatment. However, the overall 30-day mortality differed significantly between the main study and the substudy (7.76% vs 3.52%; p < 0.001). Three groups of ST-segment resolution were defined: 1. complete resolution (resolution > or = 70%; 762 patients), 2. partial resolution (< 70% and > 30%; 491 patients), 3. no resolution (< 30%; 507 patients). Mortality rate at 30 days for complete, partial and no resolution of ST-segment elevation was 1.31%, 4.28% and 6.11%, respectively (p < 0.001). While this significant correlation between the extent of ST-segment resolution and mortality could be observed for inferior acute myocardial infarction, it could not be found in patients with anterior acute myocardial infarction. This in part may be due to a selection bias that leads to an extremely divergent mortality rate of anterior acute myocardial infarction in the main study and the substudy (10.1% vs 3.94%; p < 0.0001). Despite this limitation, resolution of ST-segment elevation in acute myocardial infarction after thrombolytic therapy allows to identify patients at a high mortality risk and may help to select patients for early invasive procedures such as PTCA. Patients with complete ST-segment resolution showed a particularly low mortality rate, irrespective of the alteplase regimen used (front-loaded alteplase vs double bolus alteplase).

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Prognostic value of clinical markers of reperfusion in patients with acute myocardial infarction treated by thrombolytic therapy

Cited by 7 publications

References 28 publications

Clinical Markers of Reperfusion in Patients with Acute Myocardial Infarction and Its Prognostic Significance

Clinical Markers of Reperfusion in Patients with Acute Myocardial Infarction and Its Prognostic Significance

Relationship Between Noninvasive Reperfusion Criteria and Pulsed‐Wave Tissue Doppler Parameters in Patients With Acute Myocardial Infarction Receiving Thrombolytic Therapy

Resolution of ST-segment elevation in acute myocardial infarction — Early prognostic significance after thrombolytic therapy

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