Significance of left circumflex artery-related acute myocardial infarction without ST-T changes
Abstract Introduction Left circumflex (LC)–related acute myocardial infarction (AMI) presenting without ST-T changes has been underdiagnosed in the emergency department. There is little information on its clinical features and significance. Aims The aims of the study were to investigate the clinical...
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| Veröffentlicht in: | The American journal of emergency medicine 2010-02, Vol.28 (2), p.183-188 |
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| creator | Chua, Su-Kiat, MD Shyu, Kou-Gi, MD Cheng, Jun-Jack, MD Liou, Jer-Young, MD Lin, Sheng-Chang, MD Hung, Huei-Fong, MD Lee, Shih-Huang, MD Chiu, Chiung-Zuan, MD Lo, Huey-Ming, MD |
| description | Abstract Introduction Left circumflex (LC)–related acute myocardial infarction (AMI) presenting without ST-T changes has been underdiagnosed in the emergency department. There is little information on its clinical features and significance. Aims The aims of the study were to investigate the clinical characteristics and outcomes of LC-related AMI without ST-T changes. Population and Methods Ninety-six patients were admitted for LC-related AMI. Comparisons between those with and without ST-T changes were analyzed. Results Twenty-two patients (23%) did not have ST-T changes, whereas 74 patients (77%) had them. Patients without ST-T changes had younger age (55.6 ± 16.8 vs 62.6 ± 12.0 years, P = .03), fewer presented as Killip III/IV (4.5% vs 27.4%, P = .02) and with lower creatine kinase (1647.3 ± 1602.2 vs 2778.2 ± 2343.3 IU/L, P = .037) and creatine kinase-MB (136.8 ± 130.3 vs 247.7 ± 200.0 IU/L, P = .017), and more were with concurrent culprit lesion in the middle or distal LC and right- or balanced-dominant coronary circulation (86.4% vs 44.6%, P < .001). During follow-up, the need for repeat percutaneous coronary intervention (48.6% vs 45.5%, P = .40) and recurrent infarction (13.5% vs 13.6%, P = .62) were similar between the 2 groups. The 30-day mortality (0% vs 5.4%, P = .35) and overall mortality rate (4.5% vs 12.2%, P = .28) between them were not different statistically. Conclusion The relatively lower prevalence of LC-related AMI without ST-T changes in the study might be underestimated. These patients have smaller infarct size than patients with ST-T changes without differences in the short- and long-term outcomes between them. |
| doi_str_mv | 10.1016/j.ajem.2008.11.010 |
| format | Article |
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There is little information on its clinical features and significance. Aims The aims of the study were to investigate the clinical characteristics and outcomes of LC-related AMI without ST-T changes. Population and Methods Ninety-six patients were admitted for LC-related AMI. Comparisons between those with and without ST-T changes were analyzed. Results Twenty-two patients (23%) did not have ST-T changes, whereas 74 patients (77%) had them. Patients without ST-T changes had younger age (55.6 ± 16.8 vs 62.6 ± 12.0 years, P = .03), fewer presented as Killip III/IV (4.5% vs 27.4%, P = .02) and with lower creatine kinase (1647.3 ± 1602.2 vs 2778.2 ± 2343.3 IU/L, P = .037) and creatine kinase-MB (136.8 ± 130.3 vs 247.7 ± 200.0 IU/L, P = .017), and more were with concurrent culprit lesion in the middle or distal LC and right- or balanced-dominant coronary circulation (86.4% vs 44.6%, P < .001). During follow-up, the need for repeat percutaneous coronary intervention (48.6% vs 45.5%, P = .40) and recurrent infarction (13.5% vs 13.6%, P = .62) were similar between the 2 groups. The 30-day mortality (0% vs 5.4%, P = .35) and overall mortality rate (4.5% vs 12.2%, P = .28) between them were not different statistically. Conclusion The relatively lower prevalence of LC-related AMI without ST-T changes in the study might be underestimated. These patients have smaller infarct size than patients with ST-T changes without differences in the short- and long-term outcomes between them.</description><identifier>ISSN: 0735-6757</identifier><identifier>EISSN: 1532-8171</identifier><identifier>DOI: 10.1016/j.ajem.2008.11.010</identifier><identifier>PMID: 20159388</identifier><identifier>CODEN: AJEMEN</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Angina pectoris ; Biological and medical sciences ; Cardiology. Vascular system ; Cardiovascular disease ; Coronary Angiography ; Coronary heart disease ; Diagnostic Errors - prevention & control ; Electrocardiography ; Emergency ; Emergency medical care ; Female ; Heart ; Heart attacks ; Humans ; Intensive care medicine ; Logistic Models ; Male ; Medical sciences ; Middle Aged ; Mortality ; Multivariate Analysis ; Myocardial infarction ; Myocardial Infarction - diagnosis ; Myocardial Infarction - physiopathology ; Retrospective Studies ; Treatment Outcome ; Veins & arteries</subject><ispartof>The American journal of emergency medicine, 2010-02, Vol.28 (2), p.183-188</ispartof><rights>Elsevier Inc.</rights><rights>2010 Elsevier Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright 2010 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c468t-dc6ed748ef2514854a8bf94336b476125324eeeb303ca4dd46340e840d9d64cc3</citedby><cites>FETCH-LOGICAL-c468t-dc6ed748ef2514854a8bf94336b476125324eeeb303ca4dd46340e840d9d64cc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0735675708007985$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22560962$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20159388$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chua, Su-Kiat, MD</creatorcontrib><creatorcontrib>Shyu, Kou-Gi, MD</creatorcontrib><creatorcontrib>Cheng, Jun-Jack, MD</creatorcontrib><creatorcontrib>Liou, Jer-Young, MD</creatorcontrib><creatorcontrib>Lin, Sheng-Chang, MD</creatorcontrib><creatorcontrib>Hung, Huei-Fong, MD</creatorcontrib><creatorcontrib>Lee, Shih-Huang, MD</creatorcontrib><creatorcontrib>Chiu, Chiung-Zuan, MD</creatorcontrib><creatorcontrib>Lo, Huey-Ming, MD</creatorcontrib><title>Significance of left circumflex artery-related acute myocardial infarction without ST-T changes</title><title>The American journal of emergency medicine</title><addtitle>Am J Emerg Med</addtitle><description>Abstract Introduction Left circumflex (LC)–related acute myocardial infarction (AMI) presenting without ST-T changes has been underdiagnosed in the emergency department. There is little information on its clinical features and significance. Aims The aims of the study were to investigate the clinical characteristics and outcomes of LC-related AMI without ST-T changes. Population and Methods Ninety-six patients were admitted for LC-related AMI. Comparisons between those with and without ST-T changes were analyzed. Results Twenty-two patients (23%) did not have ST-T changes, whereas 74 patients (77%) had them. Patients without ST-T changes had younger age (55.6 ± 16.8 vs 62.6 ± 12.0 years, P = .03), fewer presented as Killip III/IV (4.5% vs 27.4%, P = .02) and with lower creatine kinase (1647.3 ± 1602.2 vs 2778.2 ± 2343.3 IU/L, P = .037) and creatine kinase-MB (136.8 ± 130.3 vs 247.7 ± 200.0 IU/L, P = .017), and more were with concurrent culprit lesion in the middle or distal LC and right- or balanced-dominant coronary circulation (86.4% vs 44.6%, P < .001). During follow-up, the need for repeat percutaneous coronary intervention (48.6% vs 45.5%, P = .40) and recurrent infarction (13.5% vs 13.6%, P = .62) were similar between the 2 groups. The 30-day mortality (0% vs 5.4%, P = .35) and overall mortality rate (4.5% vs 12.2%, P = .28) between them were not different statistically. Conclusion The relatively lower prevalence of LC-related AMI without ST-T changes in the study might be underestimated. These patients have smaller infarct size than patients with ST-T changes without differences in the short- and long-term outcomes between them.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Angina pectoris</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular disease</subject><subject>Coronary Angiography</subject><subject>Coronary heart disease</subject><subject>Diagnostic Errors - prevention & control</subject><subject>Electrocardiography</subject><subject>Emergency</subject><subject>Emergency medical care</subject><subject>Female</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multivariate Analysis</subject><subject>Myocardial infarction</subject><subject>Myocardial Infarction - diagnosis</subject><subject>Myocardial Infarction - physiopathology</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><subject>Veins & arteries</subject><issn>0735-6757</issn><issn>1532-8171</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kkGL1TAQx4so7nP1C3iQgoin1kmTJimIIIuuwoKH9zyHvGS6m5q2a5Kq79ub8p67sAdPc_n9h5nfTFG8JFATIPzdUOsBx7oBkDUhNRB4VGxIS5tKEkEeFxsQtK24aMVZ8SzGAYAQ1rKnxVkDpO2olJtCbd315Hpn9GSwnPvSY59K44JZxt7jn1KHhOFQBfQ6oS21WRKW42E2OlinfemmXgeT3DyVv126mZdUbnfVrjQ3errG-Lx40msf8cWpnhffP3_aXXyprr5dfr34eFUZxmWqrOFoBZPYNy1hsmVa7vuOUcr3THDS5KUYIu4pUKOZtYxTBigZ2M5yZgw9L94e-96G-eeCManRRYPe6wnnJSpBqZBctiKTrx-Qw7yEKQ-nCFDoGhAMMtUcKRPmGAP26ja4UYdDhtRqXw1qta9W-4oQle3n0KtT62U_or2L_NOdgTcnQEejfR-ydRfvuabl0PEmc--PHGZlvxwGFY3DfCHrApqk7Oz-P8eHB3Hj3ZRv7H_gAeP9vio2CtR2_ZP1TUACiE629C9Di7ct</recordid><startdate>20100201</startdate><enddate>20100201</enddate><creator>Chua, Su-Kiat, MD</creator><creator>Shyu, Kou-Gi, MD</creator><creator>Cheng, Jun-Jack, MD</creator><creator>Liou, Jer-Young, MD</creator><creator>Lin, Sheng-Chang, MD</creator><creator>Hung, Huei-Fong, MD</creator><creator>Lee, Shih-Huang, MD</creator><creator>Chiu, Chiung-Zuan, MD</creator><creator>Lo, Huey-Ming, MD</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20100201</creationdate><title>Significance of left circumflex artery-related acute myocardial infarction without ST-T changes</title><author>Chua, Su-Kiat, MD ; Shyu, Kou-Gi, MD ; Cheng, Jun-Jack, MD ; Liou, Jer-Young, MD ; Lin, Sheng-Chang, MD ; Hung, Huei-Fong, MD ; Lee, Shih-Huang, MD ; Chiu, Chiung-Zuan, MD ; Lo, Huey-Ming, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c468t-dc6ed748ef2514854a8bf94336b476125324eeeb303ca4dd46340e840d9d64cc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Angina pectoris</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular disease</topic><topic>Coronary Angiography</topic><topic>Coronary heart disease</topic><topic>Diagnostic Errors - prevention & control</topic><topic>Electrocardiography</topic><topic>Emergency</topic><topic>Emergency medical care</topic><topic>Female</topic><topic>Heart</topic><topic>Heart attacks</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multivariate Analysis</topic><topic>Myocardial infarction</topic><topic>Myocardial Infarction - diagnosis</topic><topic>Myocardial Infarction - physiopathology</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chua, Su-Kiat, MD</creatorcontrib><creatorcontrib>Shyu, Kou-Gi, MD</creatorcontrib><creatorcontrib>Cheng, Jun-Jack, MD</creatorcontrib><creatorcontrib>Liou, Jer-Young, MD</creatorcontrib><creatorcontrib>Lin, Sheng-Chang, MD</creatorcontrib><creatorcontrib>Hung, Huei-Fong, MD</creatorcontrib><creatorcontrib>Lee, Shih-Huang, MD</creatorcontrib><creatorcontrib>Chiu, Chiung-Zuan, MD</creatorcontrib><creatorcontrib>Lo, Huey-Ming, MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of emergency medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chua, Su-Kiat, MD</au><au>Shyu, Kou-Gi, MD</au><au>Cheng, Jun-Jack, MD</au><au>Liou, Jer-Young, MD</au><au>Lin, Sheng-Chang, MD</au><au>Hung, Huei-Fong, MD</au><au>Lee, Shih-Huang, MD</au><au>Chiu, Chiung-Zuan, MD</au><au>Lo, Huey-Ming, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Significance of left circumflex artery-related acute myocardial infarction without ST-T changes</atitle><jtitle>The American journal of emergency medicine</jtitle><addtitle>Am J Emerg Med</addtitle><date>2010-02-01</date><risdate>2010</risdate><volume>28</volume><issue>2</issue><spage>183</spage><epage>188</epage><pages>183-188</pages><issn>0735-6757</issn><eissn>1532-8171</eissn><coden>AJEMEN</coden><abstract>Abstract Introduction Left circumflex (LC)–related acute myocardial infarction (AMI) presenting without ST-T changes has been underdiagnosed in the emergency department. There is little information on its clinical features and significance. Aims The aims of the study were to investigate the clinical characteristics and outcomes of LC-related AMI without ST-T changes. Population and Methods Ninety-six patients were admitted for LC-related AMI. Comparisons between those with and without ST-T changes were analyzed. Results Twenty-two patients (23%) did not have ST-T changes, whereas 74 patients (77%) had them. Patients without ST-T changes had younger age (55.6 ± 16.8 vs 62.6 ± 12.0 years, P = .03), fewer presented as Killip III/IV (4.5% vs 27.4%, P = .02) and with lower creatine kinase (1647.3 ± 1602.2 vs 2778.2 ± 2343.3 IU/L, P = .037) and creatine kinase-MB (136.8 ± 130.3 vs 247.7 ± 200.0 IU/L, P = .017), and more were with concurrent culprit lesion in the middle or distal LC and right- or balanced-dominant coronary circulation (86.4% vs 44.6%, P < .001). During follow-up, the need for repeat percutaneous coronary intervention (48.6% vs 45.5%, P = .40) and recurrent infarction (13.5% vs 13.6%, P = .62) were similar between the 2 groups. The 30-day mortality (0% vs 5.4%, P = .35) and overall mortality rate (4.5% vs 12.2%, P = .28) between them were not different statistically. Conclusion The relatively lower prevalence of LC-related AMI without ST-T changes in the study might be underestimated. These patients have smaller infarct size than patients with ST-T changes without differences in the short- and long-term outcomes between them.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>20159388</pmid><doi>10.1016/j.ajem.2008.11.010</doi><tpages>6</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Angina pectoris Biological and medical sciences Cardiology. Vascular system Cardiovascular disease Coronary Angiography Coronary heart disease Diagnostic Errors - prevention & control Electrocardiography Emergency Emergency medical care Female Heart Heart attacks Humans Intensive care medicine Logistic Models Male Medical sciences Middle Aged Mortality Multivariate Analysis Myocardial infarction Myocardial Infarction - diagnosis Myocardial Infarction - physiopathology Retrospective Studies Treatment Outcome Veins & arteries |
| title | Significance of left circumflex artery-related acute myocardial infarction without ST-T changes |
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