Clinical outcomes of acute myocardial infarction with occluded left circumflex artery

Title
Clinical outcomes of acute myocardial infarction with occluded left circumflex artery
Author(s)
김영조김성수[김성수]최홍상[최홍상]정명호[정명호]조정관[조정관]안영근[안영근]김종현[김종현]채성철[채성철]허승호[허승호]성인환[성인환]홍택종[홍택종]최동훈[최동훈]조명찬[조명찬]김종진[김종진]승기배[승기배]정욱성[정욱성]장양수[장양수]라승운[라승운]배장호[배장호]박승정[박승정]
Keywords
ST-SEGMENT ELEVATION; CORONARY-ARTERY; POSTERIOR; OCCLUSION; ELECTROCARDIOGRAM; DIAGNOSIS; ISCHEMIA; LEADS
Issue Date
201105
Publisher
ELSEVIER IRELAND LTD
Citation
JOURNAL OF CARDIOLOGY, v.57, no.3, pp.290 - 296
Abstract
Left circumflex artery (LCX) related acute myocardial infarction (AMI) has been known to be under diagnosed with 12-lead electrocardiogram (ECG). However, there were only a few studies that have focused on the clinical characteristics of LCX-related AMI. We studied the clinical characteristics and hospital mortality in patients with angiographically confirmed LCX-related AMI. A total of 2281 AMI patients with single acutely occluded culprit vessel in coronary angiography (pre-Thrombolysis In Myocardial Infarction flow: 0) were enrolled in the Korea Acute Myocardial Infarction Registry (KAMIR) from November 2005 to January 2008. These patients were divided into three groups according to culprit vessel [left anterior descending artery (LAD), right coronary artery (RCA), and LCX]. This study showed the patients with LCX-related AMI were less likely to present with ST elevation in ECG (46.3%, 87.0%, and 82.3%; p <0.001) and primary percutaneous coronary intervention (PCI) (43.4%, 78.9%, and 74.5%; p < 0.001) and door to balloon time <90 min (31.3%, 52.8%, and 51.0%; p <0.001), compared with LAD and RCA. However, no statistical difference was found in hospital mortality among the three groups. Multivariate analysis showed primary PCI decreased the hospital mortality in patients with occluded coronary artery. In conclusion, AMI patients with an occluded LCX presented with less ST elevation and primary PCI. These results suggest that clinical physicians should be careful with patients presenting with chest pain but apparently normal ECG and must rule out LCX occlusion. (C) 2011 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
URI
http://hdl.handle.net/YU.REPOSITORY/25222http://dx.doi.org/10.1016/j.jjcc.2011.01.014
ISSN
0914-5087
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의과대학 > 내과학교실 > Articles
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