The influence of location and extent of myocardial infarction on long-term ventricular dysrhythmia and mortality.

Geltman, Edward M.; Ehsani, Ali A.; Campbell, Mary K.; Schechtman, Ken; Roberts, Robert; Sobel, Burton E.

doi:10.1161/01.cir.60.4.805

Cited by 325 publications

(68 citation statements)

References 27 publications

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“…Thus, the present study provides new information from a population more representative of patients who present to emergency departments. In a troponin-naïve population, diagnoses made according to only the more sensitive ESC/ACC criteria identify patients with intermediate risks (lower than the risks in patients positive by WHO criteria), a finding that restores the expected relationship of biomarker concentrations, severity of disease, and prognosis (22,23 ).…”

Section: Discussionmentioning

confidence: 99%

Health Outcomes Categorized by Current and Previous Definitions of Acute Myocardial Infarction in an Unselected Cohort of Troponin-Naïve Emergency Department Patients

et al. 2006

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Background:In a population originally classified for acute myocardial infarction (AMI) by the World Health Organization (WHO) definition, we compared the health outcomes after retrospectively reclassifying with the European Society of Cardiology and the American College of Cardiology (ESC/ACC) AMI definition, using the peak cardiac troponin I (cTnI) concentrations. The health outcomes were based on the WHO definition and occurred in an era that preceded the use of cardiac troponin biomarkers. Methods: For 448 patients who presented to the emergency department with symptoms suggestive of cardiac ischemia in 1996, we obtained data for all-cause mortality and recurrent AMI for up to 1 year after the initial presentation. We performed retrospective analysis of the patients' frozen plasma samples to measure cTnI (AccuTnI ® , Beckman Coulter). Results: At 30, 120, and 360 days, the risk for AMI/death in patients positive for AMI by only the ESC/ACC criteria was significantly lower than the risk in patients positive by both ESC/ACC and WHO criteria, and significantly higher than in patients negative according to both criteria. In a separate analysis, patients with a

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Section: Discussionmentioning

confidence: 99%

Health Outcomes Categorized by Current and Previous Definitions of Acute Myocardial Infarction in an Unselected Cohort of Troponin-Naïve Emergency Department Patients

et al. 2006

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“…The incidence and prognosis of heart failure and ventricular arrhythmias after acute coronary occlusion are related to myocardial infarction (MI) size (1)(2)(3)(4). The transmural extent of MI has been shown to be related to probability of functional recovery after acute revascularization (5).…”

Section: Introductionmentioning

confidence: 99%

Size and transmural extent of first-time reperfused myocardial infarction assessed by cardiac magnetic resonance can be estimated by 12-lead electrocardiogram

Engblom

Hedström

Heiberg

et al. 2005

American Heart Journal

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“…THE REASON for developing methods to assess the extent of acute myocardial infarction (AMI) arises from the hypothesis that infarct size (IS) is a major determinant of prognosis' 4 and that treatment of the ischemic injury can influence the prognosis favorably.5'…”

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confidence: 99%

Estimation of acute myocardial infarct size in man by serum CK-MB measurements.

Grande¹,

Hansen²,

Christiansen³

et al. 1982

Circulation

136

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SUMMARY This study was performed to determine the relationship between myocardial infarct size estimated by serum CK-MB methods and the extent of irreversible injury in acute myocardial infarction. In 321 consecutive patients, infarct size was estimated by different mathematical models, and in 22 patients who died in hospital, the extent of myocardial necrosis was determined by autopsy. We also investigated the depletion of CK-MB in infarcted tissue, the recovery of CK-MB in the plasma volume, and the elimination of CK-MB from plasma.Myocardial CK-MB depletion was relatively greater in the larger infarcts, whereas the recovery of enzyme in plasma was independent of the infarct size. Correction of serum CK-MB for changes in plasma volume improved the estimate significantly (p < 0.05). The correlation between the measured infarct size (g) and the estimated infarct size (units per liter and gram-equivalents) was highly significant (r = 0.85-0.89, SEE = 23-27%, p < 0.001). Thus, a semiquantitative expression of the extent of myocardial necrosis can be determined in vivo. AMI. Of these, 72 were excluded: 48 because the symptoms of AMI had lasted more than 15 hours before admission or because the second blood sample did not show higher CK-MB activity than the first and 24 because not enough blood samples had been obtained because patients died or were transferred to another department. The remaining 321 patients form the study group. Forty-three of these patients died within 18 days and were divided into group A, which included 22 patients in whom a detailed heart autopsy was performed, and group B, which included 21 patients in whom no detailed heart autopsy was performed. All patients autopsied had survived for at least 48 hours from the appearance of CK-MB activity in serum and there were no signs of reinfarction before death. Furthermore, all plasma curves showed a pure elimination phase (first-order kinetics).The 22 patients in group A included 12 women and 10 men who died at a mean age of 69.7 years (range 49-88 years). The median time from onset of symptoms until death was 6.4 days (range 2-14 days). Cardiogenic shock was the main cause of death in 12 patients and recurrent ventricular fibrillation in six patients. Two died from asystole and two from noncardiac causes.Heart biopsies were taken postmortem every 6 hours for 30 hours in eight patients from group B. The total enzyme depletion in whole heart homogenates was measured in 10 other patients.In 10 patients who died without signs of heart disease, myocardial biopsies were made to estimate CK and CK-MB activity. Tissue extracts were made from about 0.3 g tissue (wet weight) in a mixture of 10 ml 0.25 mol/ 1 sucrose, 3 ml 0.01 mol/l TRIS buffer (pH 7.4), 3 ml 1 mmol/l EGTA (pH 7.4) and 3 ml 1 mmol/ I mercaptoethanol, and homogenized on ice in an Ultra Turax blender for 1 minute. The homogenate was centrifuged (3500 g) and the supernatant was used to determine isoenzyme activity. The samples were diluted with heat-inactivated serum or TRIS buffer to the line...

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The influence of location and extent of myocardial infarction on long-term ventricular dysrhythmia and mortality.

Cited by 325 publications

References 27 publications

Health Outcomes Categorized by Current and Previous Definitions of Acute Myocardial Infarction in an Unselected Cohort of Troponin-Naïve Emergency Department Patients

Health Outcomes Categorized by Current and Previous Definitions of Acute Myocardial Infarction in an Unselected Cohort of Troponin-Naïve Emergency Department Patients

Size and transmural extent of first-time reperfused myocardial infarction assessed by cardiac magnetic resonance can be estimated by 12-lead electrocardiogram

Estimation of acute myocardial infarct size in man by serum CK-MB measurements.

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