title: Coronary artery disease in patients clinically diagnosed with myocardial infarction in the medical intensive care unit.
abstract: OBJECTIVE
  The purpose of this study is to compare the clinical characteristics and outcomes of patients with and without coronary artery disease (CAD) confirmed by coronary angiography in critically ill patients clinically diagnosed with myocardial infarction.
  
  
  METHODS
  This retrospective observational study involved 56 patients who were clinically diagnosed with myocardial infarction and subsequently underwent coronary angiography during their intensive care unit stay.
  
  
  RESULTS
  Only 18 patients (32%) were finally confirmed to have CAD by coronary angiography. There were no significant differences in laboratory findings and clinical outcomes between patients with and without CAD. However, patients who developed shock (P = .009) and needed vasopressor support (P = .021) were less likely to be diagnosed with CAD. In addition, regional wall motion abnormality on echocardiography was more frequently observed in patients with CAD (P = .072). In a multiple logistic regression analysis, male sex (adjusted odds ratio [OR], 5.093; 95% confidence interval [CI], 1.177-22.037) and focal hypokinesia on echocardiography (adjusted OR, 5.134; 95% CI, 1.071-24.614) were independently associated with CAD. However, development of shock was inversely associated with CAD (adjusted OR, 0.107; 95% CI, 0.019-0.606).
  
  
  CONCLUSIONS
  Coronary angiography in critically ill patients should only be performed in highly selected patients with predicting factors for CAD.
authors: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, 135-710, Republic of Korea.
authors: Yousang
authors: Y
authors: Ko
authors: Chi-Min
authors: CM
authors: Park
authors: Wooyoul
authors: W
authors: Kim
authors: Byeong-Ho
authors: BH
authors: Jeong
authors: Gee Young
authors: GY
authors: Suh
authors: So Yeon
authors: SY
authors: Lim
authors: O Jung
authors: OJ
authors: Kwon
authors: Kyeongman
authors: K
authors: Jeon
mesh_terms: D018806:APACHE; D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D016638:Critical Illness; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis*; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Coronary angiography; Critical illness; Intensive care unit; Myocardial infarction