Bedside markers of coronary artery patency and short-term prognosis of patients with acute myocardial infarction and thrombolysis.
Am Heart J
; 138(3 Pt 1): 533-9, 1999 Sep.
Article
em En
| MEDLINE
| ID: mdl-10467205
BACKGROUND: In this study we have evaluated the prognostic power of noninvasive markers of coronary artery reperfusion in patients with acute myocardial infarction who were treated with intravenous streptokinase. METHODS: In 967 consecutive patients with acute myocardial infarction who were treated within 6 hours of symptoms, we analyzed the prognostic power of resolution of chest pain and ST-segment elevation >50% at 90 minutes, abrupt creatine kinase rise before 12 hours, and T-wave inversion in infarct-related electrocardiographic leads within the first 24 hours after thrombolysis. RESULTS: Global in-hospital mortality rate was 12.0%. Each reperfusion marker was associated with improved outcome. Multivariate logistic regression analysis showed that 3 of the 4 markers of coronary artery reperfusion were significantly and independently associated to low in-hospital mortality rate. The presence of early T-wave inversion was associated with the lowest in-hospital mortality rate (odds ratio 0.25, confidence interval 0. 10-0.56). When all markers of coronary artery reperfusion were included in the regression model, T-wave inversion (odds ratio 0.29, confidence interval 0.11-0.68) and abrupt creatine kinase rise (odds ratio 0.36, confidence interval 0.16-0.77) continued to be significantly associated with better outcome. CONCLUSION: A systemic analysis of noninvasive markers of coronary artery reperfusion can provide the clinician with an excellent tool to predict clinical outcomes when treating myocardial infarction.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Estreptoquinase
/
Terapia Trombolítica
/
Avaliação de Resultados em Cuidados de Saúde
/
Sistemas Automatizados de Assistência Junto ao Leito
/
Fibrinolíticos
/
Infarto do Miocárdio
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Am Heart J
Ano de publicação:
1999
Tipo de documento:
Article
País de afiliação:
Chile
País de publicação:
Estados Unidos