PMID- 19005253
OWN - NLM
STAT- MEDLINE
DCOM- 20090714
LR  - 20090402
IS  - 1421-9751 (Electronic)
IS  - 0008-6312 (Linking)
VI  - 113
IP  - 1
DP  - 2009
TI  - Clinical reinfarction according to infarct location and reperfusion modality in 
      patients with ST elevation myocardial infarction. A DANAMI-2 long-term follow-up 
      substudy.
PG  - 72-80
LID - 10.1159/000171069 [doi]
AB  - OBJECTIVES: To evaluate clinical reinfarction during a 3-year follow-up after 
      randomization to primary angioplasty versus fibrinolysis in anterior and 
      non-anterior ST elevation myocardial infarction (STEMI). METHODS: Clinical 
      reinfarction was prospectively assessed by an endpoint committee blinded to the 
      study treatment. RESULTS: At 30 days, primary angioplasty compared with 
      fibrinolysis reduced the reinfarction rate both in anterior STEMI patients (n = 
      823; 2.5 vs. 5.6%, p = 0.02) and in non-anterior STEMI patients (n = 743; 0.8 vs. 
      7.4%, p < 0.001). After 3 years, the reduction in reinfarction rate was no longer 
      present in anterior STEMI patients (11.2 vs. 11.2%, p = 0.86), but persisted in 
      non-anterior STEMI patients (5.2 vs. 13.5%, p < 0.001). Reinfarction after 
      anterior STEMI carried a higher mortality than reinfarction after non-anterior 
      STEMI (37.6 vs. 15.3%, p = 0.01). Independent predictors of death were: age 
      [hazard ratio (HR) per 1-year increase in age = 1.08 (1.07-1.09)], clinical 
      reinfarction [HR = 5.15 (3.57-7.43)], anterior index STEMI [HR = 1.65 
      (1.24-2.19)], and Killip class > or =2 [HR = 1.42 (1.01-2.00)]. The additional 
      late reinfarctions after angioplasty for anterior STEMI were located within the 
      angioplasty-treated target segment. Anterior STEMI patients had smaller mean 
      target vessel diameter, which was associated with reinfarction. CONCLUSIONS: 
      Clinical reinfarction is an independent predictor of death. The early superiority 
      of primary angioplasty over fibrinolysis on reinfarction rate after anterior 
      STEMI diminished during long-term follow-up.
CI  - Copyright 2008 S. Karger AG, Basel.
FAU - Busk, Martin
AU  - Busk M
AD  - Department of Cardiology, Aarhus University Hospital Skejby, Aarhus, Denmark.
FAU - Kristensen, Steen D
AU  - Kristensen SD
FAU - Rasmussen, Klaus
AU  - Rasmussen K
FAU - Kelbaek, Henning
AU  - Kelbaek H
FAU - Thayssen, Per
AU  - Thayssen P
FAU - Madsen, Jan K
AU  - Madsen JK
FAU - Abildgaard, Ulrik
AU  - Abildgaard U
FAU - Krusell, Lars R
AU  - Krusell LR
FAU - Mortensen, Leif S
AU  - Mortensen LS
FAU - Thuesen, Leif
AU  - Thuesen L
FAU - Andersen, Henning R
AU  - Andersen HR
FAU - Nielsen, Torsten T
AU  - Nielsen TT
CN  - DANAMI-2 Investigators
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20081113
PL  - Switzerland
TA  - Cardiology
JT  - Cardiology
JID - 1266406
SB  - IM
MH  - Aged
MH  - Denmark/epidemiology
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multicenter Studies as Topic
MH  - Myocardial Infarction/*etiology/mortality/pathology
MH  - Myocardial Reperfusion/*methods
MH  - Myocardium/*pathology
MH  - Randomized Controlled Trials as Topic
MH  - Recurrence
EDAT- 2008/11/14 09:00
MHDA- 2009/07/15 09:00
CRDT- 2008/11/14 09:00
PHST- 2008/03/05 00:00 [received]
PHST- 2008/06/06 00:00 [accepted]
PHST- 2008/11/14 09:00 [pubmed]
PHST- 2009/07/15 09:00 [medline]
PHST- 2008/11/14 09:00 [entrez]
AID - 000171069 [pii]
AID - 10.1159/000171069 [doi]
PST - ppublish
SO  - Cardiology. 2009;113(1):72-80. doi: 10.1159/000171069. Epub 2008 Nov 13.