Relationship of left ventricular end-diastolic pressure with extent of myocardial ischemia, myocardial salvage and long-term outcome in patients with ST-segment elevation myocardial infarction

Ndrepepa G, Cassese S, Hashorva D, Kufner S, Xhepa E, Hasimi E, Fusaro M, Laugwitz KL, Schunkert H, Kastrati A (2019)


Publication Type: Journal article

Publication year: 2019

Journal

Book Volume: 93

Pages Range: 901-909

Journal Issue: 5

DOI: 10.1002/ccd.28098

Abstract

Objectives: We aimed to assess the association of left ventricular end-diastolic pressure (LVEDP) with myocardial salvage and long-term mortality in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). Background: The association of LVEDP with myocardial salvage or long-term mortality in patients with STEMI has not been investigated. Methods: This study included 1,312 patients with STEMI undergoing primary PCI between 2002 and 2007. LVEDP was measured at the time of intervention. Patients were divided into three groups: a group with LVEDP in the 1st tertile (LVEDP, 4–19 mmHg; n = 496), a group with LVEDP in the 2nd tertile (LVEDP >19–24 mmHg; n = 410) and a group with LVEDP in the 3rd tertile (LVEDP >24–45 mmHg; n = 406). The primary outcome was 8-year cardiac mortality. Results: The primary outcome (cardiac deaths) occurred in 114 patients. Deaths occurred in 26 (7.9%), 36 (11.5%), and 52 (16.4%) patients with LVEDP in the 1st to 3rd tertiles, respectively (adjusted hazard ratio = 1.18, 95% confidence interval 1.02–1.36, P = 0.022, for 5 mmHg increment in the LVEDP values). LVEDP correlated with the extent of myocardial ischemia (R = 0.351; P < 0.001). In patients with LVEDP in the 1st to 3rd tertiles, the salvage index (proportion of initial area at risk salvaged) was 0.53 [0.27–0.84], 0.53 [0.28–0.80], and 0.43 [0.18–0.75], respectively (P = 0.012). After adjustment, LVEDP correlated inversely with myocardial salvage (P < 0.001). Conclusions: In patients with STEMI, elevated LVEDP correlated with the extent of myocardial ischemia, reduced myocardial salvage and increased risk of 8-year cardiac mortality.

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How to cite

APA:

Ndrepepa, G., Cassese, S., Hashorva, D., Kufner, S., Xhepa, E., Hasimi, E.,... Kastrati, A. (2019). Relationship of left ventricular end-diastolic pressure with extent of myocardial ischemia, myocardial salvage and long-term outcome in patients with ST-segment elevation myocardial infarction. Catheterization and Cardiovascular Interventions, 93(5), 901-909. https://doi.org/10.1002/ccd.28098

MLA:

Ndrepepa, Gjin, et al. "Relationship of left ventricular end-diastolic pressure with extent of myocardial ischemia, myocardial salvage and long-term outcome in patients with ST-segment elevation myocardial infarction." Catheterization and Cardiovascular Interventions 93.5 (2019): 901-909.

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