The "open artery hypothesis" in survivors of myocardial infarction.
In survivors of acute myocardial infarction, the restoration of antegrade flow in the infarct-related coronary artery may improve prognosis by a mechanism independent of its effect on left ventricular function. Survival may be enhanced even when restoration of flow is accomplished days or weeks after the acute event. In a series of retrospective studies of survivors of a first myocardial infarction, it was shown that long-term survival is significantly better in those with than in those without antegrade flow in the infarct-related artery. It is hypothesized that late restoration of antegrade flow in the infarct-related artery renders the border zone of the infarction more electrically stable, thereby diminishing the incidence of ventricular tachyarrhythmias and sudden death.
Pitts
W R
WR
Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas 75235-9047, USA.
Cigarroa
J E
JE
Lange
R A
RA
Hillis
L D
LD
D000328:Adult; D003324:Coronary Artery Disease / Q000150:complications* / Q000628:therapy*; D006801:Humans; D015993:Life Tables; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality* / Q000628:therapy; D009204:Myocardial Revascularization; D012189:Retrospective Studies; D014654:Vascular Patency