PMID- 20453641
OWN - NLM
STAT- MEDLINE
DCOM- 20110418
LR  - 20220331
IS  - 1473-5830 (Electronic)
IS  - 0954-6928 (Linking)
VI  - 21
IP  - 6
DP  - 2010 Sep
TI  - Predictive value of ischemic mitral regurgitation during the acute phase of ST 
      elevation myocardial infarction treated with primary coronary intervention for 
      left ventricular remodeling in long-term follow-up.
PG  - 325-9
LID - 10.1097/MCA.0b013e32833aa6bb [doi]
AB  - Reperfusion therapy, mainly primary percutaneous coronary intervention (PCI), has 
      improved survival and lowered complication rate in patients with ST elevation 
      myocardial infarction (STEMI). Nevertheless, some patients develop left 
      ventricular remodeling (LVR) during long-term follow-up. AIMS: To assess the 
      incidence of ischemic mitral regurgitation (MR) in the acute phase of STEMI 
      treated with primary PCI. To assess prognostic value of MR during acute STEMI for 
      prediction of LVR during long-term follow-up. METHODS: This is a prospective, 
      single-center study in 83 patients with the first STEMI. Inclusion criteria were 
      as follows: time from symptom onset to PCI less than 12 h and successful 
      restoration of blood flow (thrombolysis in myocardial infarction 3) in the 
      infarct-related coronary artery. Transthoracic echocardiography was performed at 
      discharge and 6 months after the MI. RESULTS: At hospital discharge, ischemic MR 
      was found in 35 (42%) patients. At 6 months follow-up, LVR was present in 21 
      (25%) patients. Univariate analysis revealed that remodeling could be predicted 
      by age, weight, treatment with abciximab, left ventricular ejection fraction 
      (LVEF), leaflets coaptation, coaptation height, tenting area, presence of MR, 
      degree of MR. The best multivariate logistic regression model for remodeling 
      prediction at 6 months was combination of ischemic MR degree (odds ratio 
      (OR)=14.5; 95% confidence interval (CI): 3.89-54.0, P<0.00005), abciximab therapy 
      (OR=0.09; 95% CI: 0.01-0.84, P<0.03) and LVEF (OR=0.89; 95% CI: 0.81-0.99, 
      P<0.03). CONCLUSION: Ischemic MR in STEMI is frequent, even despite effective 
      primary PCI. The regurgitation grade and lower LVEF assessed at hospital 
      discharge and lack of abciximab administration could predict development of LVR 
      at 6 months.
FAU - Wita, Krystian
AU  - Wita K
AD  - Department of Cardiology, Medical University of Silesia, Katowice, Poland.
FAU - Berger-Kucza, Adrianna
AU  - Berger-Kucza A
FAU - Filipecki, Artur
AU  - Filipecki A
FAU - Turski, Maciej
AU  - Turski M
FAU - Bochenek, Tomasz
AU  - Bochenek T
FAU - Wrobel, Wojciech
AU  - Wrobel W
FAU - Lelek, Michal
AU  - Lelek M
FAU - Weglarz, Przemyslaw
AU  - Weglarz P
FAU - Elzbieciak, Marek
AU  - Elzbieciak M
FAU - Trusz-Gluza, Maria
AU  - Trusz-Gluza M
LA  - eng
PT  - Journal Article
PL  - England
TA  - Coron Artery Dis
JT  - Coronary artery disease
JID - 9011445
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Immunoglobulin Fab Fragments)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - X85G7936GV (Abciximab)
SB  - IM
MH  - Abciximab
MH  - Aged
MH  - *Angioplasty, Balloon, Coronary/adverse effects
MH  - Antibodies, Monoclonal/therapeutic use
MH  - Echocardiography, Doppler, Color
MH  - Female
MH  - Humans
MH  - Immunoglobulin Fab Fragments/therapeutic use
MH  - Incidence
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve Insufficiency/diagnostic imaging/*etiology/physiopathology
MH  - Myocardial Infarction/complications/diagnostic imaging/physiopathology/*therapy
MH  - Odds Ratio
MH  - Patient Discharge
MH  - Platelet Aggregation Inhibitors/therapeutic use
MH  - Poland
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Stroke Volume
MH  - Time Factors
MH  - Treatment Outcome
MH  - *Ventricular Function, Left
MH  - *Ventricular Remodeling
EDAT- 2010/05/11 06:00
MHDA- 2011/04/19 06:00
CRDT- 2010/05/11 06:00
PHST- 2010/05/11 06:00 [entrez]
PHST- 2010/05/11 06:00 [pubmed]
PHST- 2011/04/19 06:00 [medline]
AID - 10.1097/MCA.0b013e32833aa6bb [doi]
PST - ppublish
SO  - Coron Artery Dis. 2010 Sep;21(6):325-9. doi: 10.1097/MCA.0b013e32833aa6bb.