title: [Predictive factors of deteriorating left ventricular function after direct percutaneous coronary intervention for acute anterior myocardial infarction].
abstract: OBJECTIVE
  To evaluate useful predictors for the deterioration of left ventricular function after direct percutaneous coronary intervention in patients with acute myocardial infarction.
  
  
  METHODS
  This study included 96 consecutive patients with first acute anterior myocardial infarction reperfused successfully by direct percutaneous coronary intervention within 6 hr of the onset, who underwent left ventriculography in the acute (soon after reperfusion therapy) and chronic (20 +/- 8 days after onset) phases. The left ventricular ejection fraction (LVEF), and the difference in LVEF (delta LVEF) between the two stages were calculated. The patients were divided into two groups according to the delta LVEF (low delta LVEF group: delta LVEF < 0%, n = 30; high delta LVEF group: delta LVEF > or = 0%, n = 66).
  
  
  RESULTS
  There were significantly more patients with diabetes mellitus (53% vs 18%, p = 0.0009), older age (73 +/- 11 vs 67 +/- 12 years, p = 0.003) and complete occlusion of the culprit artery (13% vs 35%, p = 0.03) in the low delta LVEF group than in the high delta LVEF group. Left ventricular end-diastolic volume index (LVEDVI: 75 +/- 14 vs 62 +/- 15 ml/m2, p = 0.002) in the chronic stage and delta LVEDVI(5 +/- 8 vs -3 +/- 14 ml/m2, p = 0.04) were significantly worse in the low delta LVEF group than in the high delta LVEF group. Multivariate analysis identified diabetes mellitus as the only independent predictor of reduction of LVEF (odds ratio 4.44, 95% confidence interval 1.27-15.52, p = 0.02).
  
  
  CONCLUSIONS
  Some patients with acute anterior myocardial infarction treated by direct percutaneous coronary intervention had reduction of the LVEF. There was a close relationship between reduction of the LVEF and left ventricular remodeling. Diabetes mellitus was the most useful predictor of reduction of the LVEF.
authors.affiliation: Department of Cardiology, Nagasaki Citizens Hospital, Nagasaki.
authors.forename: Toshiro
authors.initials: T
authors.lastname: Katayama
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakashima
authors.forename: Shinnosuke
authors.initials: S
authors.lastname: Furudono
authors.forename: Yukiharu
authors.initials: Y
authors.lastname: Honda
authors.forename: Shin
authors.initials: S
authors.lastname: Suzuki
authors.forename: Katsusuke
authors.initials: K
authors.lastname: Yano
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D048909:Diabetes Complications; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology* / Q000628:therapy; D009206:Myocardium / Q000473:pathology; D013318:Stroke Volume; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling