title: Left ventricular apical aneurysm following primary percutaneous coronary intervention.
abstract: Left ventricular apical aneurysm (LVAA) is a serious complication of acute anterior myocardial infarction (MI). The purpose of our study was to investigate the clinical features of LVAA in the primary PCI era. A total of 161 acute anterior MI patients who had primary PCI and had an echocardiogram on chronic phase were included. The development of LVAA was reviewed on chronic phase. Univariate and multivariate logistic regression analyses were performed to identify the predictors of LVAA. Primary stenting was performed in 160 patients (99.4 %). Procedural success was obtained in all patients with a final TIMI flow grade 3 obtained in 142 patients (88.2 %). LVAA developed in the chronic phase in 29 patients (18.0 %). Multivariate logistic regression analysis revealed that peak CK (500 mU/ml increase; OR 1.24, 95 % CI 1.09-1.41, p = 0.001), heart rate at discharge (5/min increase; OR 1.39, 95 % CI 1.03-1.87, p = 0.03), final TIMI flow grade ≤2 (vs. TIMI 3; OR 6.95, 95 % CI 1.70-28.36, p = 0.01) and final myocardial brush grade (MBG) ≤2 (vs. MBG 3; OR 4.33, 95 % CI 1.06-17.66, p = 0.04) were significantly associated with the development of LVAA. The initial TIMI flow grade or the grade of collateral flow was not associated with LVAA. In conclusion, peak CK, heart rate, and final TIMI flow grade or final MBG ≤2 were significantly associated with the development of LVAA. Achieving a TIMI flow grade 3 by primary PCI may be important for preventing LVAA.
authors.affiliation: Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Amanuma 1-847, Omiya, Saitama, 330-8503, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Mori
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sakakura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Wada
authors.forename: Nahoko
authors.initials: N
authors.lastname: Ikeda
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Jinnouchi
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Sugawara
authors.forename: Norifumi
authors.initials: N
authors.lastname: Kubo
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Momomura
authors.forename: Junya
authors.initials: J
authors.lastname: Ako
mesh_terms: D000368:Aged; D056988:Anterior Wall Myocardial Infarction / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D015415:Biomarkers / Q000097:blood; D003326:Coronary Circulation; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D006322:Heart Aneurysm / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D006339:Heart Rate; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D003402:Creatine Kinase