Key result
Acute LAD or LCx occlusion in AMI linked to ~380% higher out-of-hospital VF risk vs RCA.
Why the study?
More than half of AMI-associated deaths occur out of the hospital within 1 hour of symptom onset, but the angiographic determinants of out-of-hospital VF in AMI have not been investigated in detail.
Does the location of acute coronary occlusion affect the risk of out-of-hospital ventricular fibrillation in patients with acute myocardial infarction?
Case-Control (n=216)
Does the location of acute coronary occlusion affect the risk of out-of-hospital ventricular fibrillation in patients with acute myocardial infarction?
Effect estimate: OR 4.82 (LAD); OR 4.92 (LCx) (95% CI 2.35-9.92 (LAD); 2.34-10.39 (LCx))
In patients with acute myocardial infarction, occlusion of the left coronary artery (LAD or LCx) is associated with a nearly 5-fold greater risk for out-of-hospital ventricular fibrillation compared to right coronary artery occlusion.
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Left coronary occlusion signals higher out-of-hospital VF risk in AMI; extends anatomic risk mapping for targeted prevention trials.
Gheeraert et al. (2000) conducted a case-control in Acute myocardial infarction (n=216). Left anterior descending (LAD) or left circumflex (LCx) coronary artery occlusion vs. Right coronary artery (RCA) occlusion was evaluated on Out-of-hospital ventricular fibrillation (OR 4.82 (LAD); OR 4.92 (LCx), 95% CI 2.35-9.92 (LAD); 2.34-10.39 (LCx)). Acute occlusion of the LAD or LCx in AMI patients was associated with a higher risk of out-of-hospital ventricular fibrillation compared to RCA occlusion (OR 4.82 and 4.92, respectively).
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