Total occlusion of the left anterior descending artery combined with poor collateral blood supply (score 0.9 vs 2.4, p<0.001) is a significant determinant of left ventricular aneurysm formation.
Observational (n=79)
Total occlusion of the left anterior descending artery combined with poor collateral blood supply is a major determinant of left ventricular aneurysm formation after anterior myocardial infarction.
p-value: p=<0.001
To determine factors involved in left ventricular aneurysm formation after transmural anterior myocardial infarction, 79 patients with a first myocardial infarction who underwent cardiac catheterization within 6 months of infarction were evaluated. Patients who had received thrombolytic therapy were excluded. Patients were divided into four groups depending on the status of the left anterior descending artery and the presence or absence of a left ventricular aneurysm: Group I (n = 25): aneurysm with occluded left anterior descending artery; Group II (n = 27): no aneurysm and occluded left anterior descending artery; Group III (n = 23): no aneurysm and patent left anterior descending artery; and Group IV (n = 4): aneurysm with patent left anterior descending artery. Single vessel disease was more common in Group I (aneurysm) compared with Groups II and III (no aneurysm) (chi 2(4) = 12.8; probability value equal to 0.012). Collateral blood supply in the presence of an occluded left anterior descending artery was significantly less in Group I (aneurysm) compared with Group II (no aneurysm) (0.9 versus 2.4, p less than 0.001). The extent of coronary artery disease and collateral blood supply in Groups I and II were directly related (p = 0.012). Neither age, sex nor risk factors for coronary disease correlated with aneurysm formation. At a mean follow-up of 48 months, no differences were observed in the incidence of recurrent angina, new myocardial infarction, embolic events or sudden death. More patients in Group II underwent coronary artery bypass surgery. Total occlusion of the left anterior descending artery in association with inherent poor collateral blood supply is a significant determinant of aneurysm formation after anterior myocardial infarction. Multivessel disease with either good collateral circulation or a patent left anterior descending artery is uncommonly associated with the development of left ventricular aneurysm.
Forman et al. (Mon,) conducted a observational in Transmural anterior myocardial infarction (n=79). Occluded left anterior descending artery vs. Patent left anterior descending artery or good collateral blood supply was evaluated on Left ventricular aneurysm formation (p=<0.001). Total occlusion of the left anterior descending artery combined with poor collateral blood supply (score 0.9 vs 2.4, p<0.001) is a significant determinant of left ventricular aneurysm formation.