Primary reperfusion in acute right ventricular infarction: An observational study
AIM: To investigate the impact of primary reperfusion therapy(RT) on early and late mortality in acute right ventricular infarction(RVI). METHODS: RVI patients(n = 679) were prospectivelyclassified as without right ventricular failure(RVF)(class A, n = 425, 64%), with RVF(class B, n = 158, 24%) or w...
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Published in | World journal of cardiology Vol. 6; no. 1; pp. 14 - 22 |
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Main Author | |
Format | Journal Article |
Language | English |
Published |
United States
Baishideng Publishing Group Co., Limited
26.01.2014
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Subjects | |
Online Access | Get full text |
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Summary: | AIM: To investigate the impact of primary reperfusion therapy(RT) on early and late mortality in acute right ventricular infarction(RVI). METHODS: RVI patients(n = 679) were prospectivelyclassified as without right ventricular failure(RVF)(class A, n = 425, 64%), with RVF(class B, n = 158, 24%) or with cardiogenic shock(CS)(class C, n = 96, 12%). Of the 679 patients, 148(21.7%) were considered to be eligible for thrombolytic therapy(TT) and 351(51.6%) for primary percutaneous coronary intervention(PPCI). TIMI 3-flow by TT was achieved for A, B and C RVI class in 65%, 64% and 0%, respectively and with PPCI in 93%, 91% and 87%, respectively. RESULTS: For class A without RT, the mortality rate was 7.9%, with TT was reduced to 4.4%(P < 0.01) and with PPCI to 3.2%(P < 0.01). Considering TT vs PPCI, PPCI was superior(P < 0.05). For class B without RT the mortality was 27%, decreased to 13% with TT(P < 0.01) and to 8.3% with PPCI(P < 0.01). In a TT and PPCI comparison, PPCI was superior(P < 0.01). For class C without RT the in-hospital mortality was 80%, with TT was 100% and with PPCI, the rate decreased to 44%(P < 0.01). At 8 years, the mortality rate without RT for class A was 32%, for class B was 48% and for class C was 85%. When PPCI was successful, the longterm mortality was lower than previously reported for the 3 RVI classes(A: 21%, B: 38%, C: 70%; P < 0.001). CONCLUSION: PPCI is superior to TT and reduces short/long-term mortality for all RVI categories. RVI CS patients should be encouraged to undergo PPCI at a specialized center. |
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Bibliography: | Eulo Lupi-Herrera;Héctor González-Pacheco;úrsulo Juárez-Herrera;Nilda Espinola-Zavaleta;Eduardo Chuquiure-Valenzuela;Ramón Villavicencio-Fernández;Marco Antonio Pea-Duque;Ernesto Ban-Hayashi;Sergio Férez-Santander;The American British Cowdray Medical Center I.A.P.;Chuquiure-Valenzuela,Coronary Care Unit,National Institute of Cardiology Ignacio Chavez;Marco Antonio Pea-Duque,Ernesto Ban-Hayashi,Echocar- diography and Interventional Cardiology Departments,National Institute of Cardiology Ignacio Chavez;Coronary Care Unit,National Institute of Cardiology Ignacio Chavez;Echocar- diography and Interventional Cardiology Departments,National Institute of Cardiology Ignacio Chavez;Subdivisions of Clinical-Research and Teaching,National Institute of Cardiology Ignacio Chavez ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Author contributions: Lupi-Herrera E designed, performed the research, analyzed the obtained data and wrote the manuscript; González-Pacheco H, Juárez-Herrera Ú, Chuquiure-Valenzuela E performed the research, wrote the manuscript and analyzed the obtained data; Villavicencio-Fernández R, Peña-Duque MA, and Ban-Hayashi E performed the cardiac catheterization studies and primary percutaneous coronary intervention; Espinola-Zavaleta N analyzed the echocardiographic studies, provided new reagents and also were involved in writing and editing the manuscript; Férez-Santander S was involved in editing the manuscript. Telephone: +52-33-308000 Fax: +52-33-308000 Correspondence to: Eulo Lupi-Herrera, MD, FACC, Director of the Cardiovascular Division, The American British Cowdray Medical Center I.A.P., Sur 136-116, Col Las Américas, Mexico City 14080, Mexico. elupih@abchospital.com |
ISSN: | 1949-8462 1949-8462 |
DOI: | 10.4330/wjc.v6.i1.14 |