Angiographic predictors of left ventricular ejection fraction after successful angioplasty in acute myocardial infarction: an angiographic risk score for use in the catheterization laboratory.
We investigated the value of angiographic parameters in patients with successful primary angioplasty using a simple angiographic risk score. In 608 consecutive patients, we assessed the infarct-related artery, antegrade flow before treatment, presence of distal embolization, and myocardial blush grade after coronary angioplasty. LAD-related infarction (OR = 8.4; 3 points), TIMI 0-2 flow before angioplasty (OR = 2.2; 1 point), myocardial blush 0 or 1 (OR = 2.5; 1 point), and distal embolization (OR = 2.2; 1 point) were independent predictors of left ventricular ejection fraction (LVEF) < or = 40% after successful angioplasty. Patients with 0 (minimum) or 1 point have LVEF of 49.5% +/- 8.4% and 30-day mortality of 0.8%. Patients with 2-3 points have LVEF of 44.9% +/- 10.3% and 30-day mortality of 2.8%. Patients with 4 points have LVEF of 38.2% +/- 10.8% and 30-day mortality of 2.7%. Patients with 5-6 (maximum) points have LVEF of 32.0% +/- 9.4% and 30-day mortality of 6.9%. A simple angiographic score predicts LVEF and mortality in patients when leaving the catheterization laboratory after successful primary angioplasty for acute myocardial infarction.
Department of Cardiology, Isala Klinieken, Zwolle, The Netherlands. v.derks@diagram-zwolle.nl
Jose P S
JP
Henriques
Felix
F
Zijlstra
Jan Paul
JP
Ottervanger
Menko-Jan
MJ
de Boer
Jan-Henk E
JH
Dambrink
A T Marcel
AT
Gosselink
Arnoud W J
AW
van 't Hof
Jan C A
JC
Hoorntje
Harry
H
Suryapranata
D015906:Angioplasty, Balloon, Coronary; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D007755:Laboratories, Hospital; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000628:therapy*; D015425:Myocardial Reperfusion; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011877:Radionuclide Imaging; D013318:Stroke Volume; D016277:Ventricular Function, Left / Q000502:physiology