The Long-term Clinical Prognosis in Patients with Anterior Wall and Non-anterior Wall Acute Myocardial Infarction Referred to Primary Percutaneous Transluminal Coronary Angioplasty
Objective: To investigate the long-term clinical prognosis in patients with anterior wall acute myocardial infarction (AW-AMI) and non AW-AMI (NAW-AMI) referred to primary percutaneous transluminal coronary angioplasty (P-PTCA). Methods: 287 patients with AMI who underwent P-PTCA were divided into AW-AMI group (142 cases) and NAW AMI group (145 cases) according to different sites of AMI. The baseline characteristics and coronary artery lesions of patients were analysed. The primary end points were in-hospital mortality and the major cardiovascular events (MACE) during a mean 17.3±9.8 months follow-up including the occurrences of non-fatal myocardial infarction, non-fatal congestive heart failure, revascularization of target vessels and overall cardiac-related death. Results: The peak values of CK and CK-MB were significantly higher (3533±2888 U/L vs 2322±1638 U/L, 158±197 U/L vs 95±64 U/L, all P < 0.01), and left ventricular ejection fraction decreased (0.55±0.13 vs 0.61±0.12, P < 0.05) and in- hospital mortality increased significantly (4.1% vs 0, P < 0.05) in AW-AMI group than in NAW-AMI group. At a follow-up of mean 17.3±9.8 months, the incidences of non-fatal heart failure, in-hospital mortality, total cardiac- related mortality and combined end points in AW-AMI group increased significantly than those in NAW-AMI group (all P < 0.05). Multivariate analysis revealed that anterior location of myocardial infarction and proximal left anterior descending (LAD) coronary artery lesion were associated with the occurrence of cardiac-related death in patients with AMI after procedure of PTCA (all P < 0.05). Conclusions: The present study shows that anterior location of myocardial infarction is associated with a higher incidence of MACE. The long-term clinical outcomes are poorer in patients with AW-AMI than NAW-AMI referred to P-PTCA.
Mingzhong Zhao, Dayi Hu, Tianchang Li, Sanqing Jia, The Long-term Clinical Prognosis in Patients with Anterior Wall and Non-anterior Wall Acute Myocardial Infarction Referred to Primary Percutaneous Transluminal Coronary Angioplasty Journal of the Hong Kong College of Cardiology 2002;10(1) https://doi.org/10.55503/2790-6744.1183