Key result
Patients with non-Q-wave myocardial infarction and viable myocardium who underwent revascularization had a 6% mortality rate, compared to 27-33% in patients with Q-wave MI or without viability.
Why the study?
Does the presence of viable myocardium and subsequent revascularization improve mortality in patients with non-Q-wave myocardial infarction compared to Q-wave myocardial infarction?
Observational (n=175)
Does the presence of viable myocardium and subsequent revascularization improve mortality in patients with non-Q-wave myocardial infarction compared to Q-wave myocardial infarction?
Patients with non-Q-wave myocardial infarction and viable myocardium have a significantly better prognosis after revascularization compared to those with Q-wave MI or without viable myocardium.
Viability assessment may inform revascularization decisions in non-Q-wave MI; hypothesis-generating and requires randomized confirmation.
This study assessed the amount and prognostic value of myocardial viability in patients with non-Q-wave myocardial infarction (NQMI) and Q-wave myocardial infarction (QMI). A total of 175 patients with MI and an ejection fraction < or = 45% underwent dobutamine stress echocardiography. On the basis of clinical criteria and myocardial viability, 110 patients were revascularized. The amount of viable myocardium and the clinical outcome were compared in the NQMI and QMI groups. Patients with NQMI exhibited a larger amount of viable myocardium compared with those with QMI. The mortality rate was 6% in patients with NQMI with viable myocardium and subsequent revascularization, 33% in patients with NQMI without viable myocardium or revascularization, 27% in patients with QMI with viable myocardium and subsequent revascularization, and 33% in patients with QMI without viable myocardium or revascularization. In conclusion, our data suggest that patients with NQMI and viable myocardium have the best prognosis after revascularization.
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Baran et al. (2005) conducted an observational in Non-Q-wave and Q-wave Myocardial Infarction (n=175). Revascularization in the presence of viable myocardium vs. No revascularization or no viable myocardium was evaluated on Mortality rate. Patients with non-Q-wave myocardial infarction and viable myocardium who underwent revascularization had a 6% mortality rate, compared to 27-33% in patients with Q-wave MI or without viability.
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