Husser, Oliver and Bodi, Vicente and Sanchis, Juan and Nunez, Julio and Lopez-Lereu, Maria P. and Monmeneu, Jose V. and Gomez, Cristina and Rumiz, Eva and Merlos, Pilar and Bonanad, Clara and Minana, Gema and Valero, Ernesto and Chaustre, Fabian and Forteza, Maria J. and Riegger, Guenter A. J. and Chorro, Francisco J. and Llacer, Angel (2013) Predictors of cardiovascular magnetic resonance-derived microvascular obstruction on patient admission in STEMI. INTERNATIONAL JOURNAL OF CARDIOLOGY, 166 (1). pp. 77-84. ISSN 0167-5273,
Full text not available from this repository. (Request a copy)Abstract
Background: Early stratification of patients according to the risk for developing microvascular obstruction (MVO) after ST-segment elevation myocardial infarction (STEMI) is desirable. We aimed to identify predictors of cardiovascular magnetic resonance (CMR)-derived MVO from clinical + ECG, laboratory and angiographic parameters available on admission. Methods: Characteristics available on admission were documented in 97 STEMI patients referred for primary angioplasty. MVO was determined using contrast-enhanced CMR. Results: MVO was present in 44 patients (45%). The C-statistic for predicting MVO was: clinical + ECG (.832), laboratory (.743), and angiographic parameters (.669). Adding laboratory to clinical + ECG information did not improve the C-statistic (.873 vs. .832, p = .2). Further addition of angiographic data (.904) improved the C-statistic of clinical + ECG (p =. 04) but not of clinical + ECG and laboratory (p = .2). Independent predictors of MVO using clinical and ECG parameters were: Killip class >1 (OR 15.97 95%CI [1.37-186.76], p = .03), diabetes (OR 6.15 95%CI [1.49-25.39], p = .01), age <55 years (OR 4.70 95%CI [1.56-14.17], p = .006), sum of ST-segment elevation >10 mm (OR 4.5 95%CI [1.58-12.69], p = .005) and delayed presentation >3 h (OR 3.80 95%CI [1.19-12.1], p = .02). A score was constructed assigning Killip class >1 2 points and the remaining indexes 1 point. The incidence of MVO increased with the score: 0 point: 8.7%; 1 point: 28.1%; 2 points: 71.4%; and 3+ points: 93% (p < .0001). Conclusions: MVO can be predicted using parameters already available on patient admission. We developed a clinical-ECG score allowing for early and reliable classification of STEMI patients according to the risk of MVO. (c) 2011 Elsevier Ireland Ltd. All rights reserved.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ACUTE MYOCARDIAL-INFARCTION; ST-SEGMENT ELEVATION; PERCUTANEOUS CORONARY INTERVENTION; PRIMARY ANGIOPLASTY; PROGNOSTIC-SIGNIFICANCE; NO-REFLOW; REPERFUSION; RECOVERY; SIZE; ECHOCARDIOGRAPHY; Cardiovascular magnetic resonance; ST-elevation myocardial infarction; Microvascular obstruction |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 07 Apr 2020 12:31 |
| Last Modified: | 07 Apr 2020 12:31 |
| URI: | https://pred.uni-regensburg.de/id/eprint/16519 |
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