Key result
Primary angioplasty for acute ST-elevation myocardial infarction resulted in preserved mean LVEF of 57% and a reduction in mean perfusion defect from 19% at 1 week to 15% at 20 months.
Why the study?
How do left ventricular function and infarct size change over long-term follow-up after primary angioplasty for acute ST-elevation myocardial infarction?
Observational (n=100)
How do left ventricular function and infarct size change over long-term follow-up after primary angioplasty for acute ST-elevation myocardial infarction?
Following primary angioplasty for acute STEMI, left ventricular function is well preserved long-term, and initial reductions in infarct size stabilize after 6 weeks.
Supports preserved LVEF long-term after primary angioplasty in STEMI; leaves open whether perfusion changes affect outcomes in prospective trials.
Objective-To study changes in left ventricular function and infarct size during long-term follow-up after acute myocardial infarction treated with primary angioplasty.Design-From 1996 to 1998, 100 consecutive patients were treated with primary angioplasty for acute ST-elevation myocardial infarction.Angioplasty was successful in 95% of the patients.Global left ventricular ejection fraction (LVEF) was determined by radionuclide ventriculography before discharge, after 6 weeks and after a mean followup time of 20 months.Infarct size was assessed by technetium 99m-tetrofosmin myocardial perfusion tomography (SPECT) at rest, performed at the same time intervals.Results -Mean LVEF was 56% at discharge, 55% after 6 weeks and 57% after 20 months of follow-up.No signi cant improvement in LVEF was observed.Only 8% of the patients at follow-up had LVEF lower than 40%.After 1 week, a mean perfusion defect of 19% was measured by SPECT.After 6 weeks and 20 months of follow-up, the mean perfusion defects were reduced to 14% (p < 0.001) and 15%, respectively.Conclusion -Left ventricular function was well preserved with a mean LVEF of 57% 20 months after primary angioplasty for acute myocardial infarction.No signi cant change in LVEF was observed from 1 week after angioplasty to follow-up.Infarct sizes as assessed by SPECT imaging with tetrofosmin were reduced from 1 to 6 weeks, but did not change further during long-term follow-up.The reduction in the perfusion defects over time was probably due to gradual relief of stunning.
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Halvorsen et al. (2001) conducted an observational in Acute ST-elevation myocardial infarction (n=100). Primary angioplasty was evaluated on Changes in left ventricular ejection fraction (LVEF) and infarct size (perfusion defect) (p=<0.001). Primary angioplasty for acute ST-elevation myocardial infarction resulted in preserved mean LVEF of 57% and a reduction in mean perfusion defect from 19% at 1 week to 15% at 20 months.
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