Prevalence of spontaneous reperfusion and associated myocardial salvage in patients with acute myocardial infarction

T. F. Christian, J. J. Milavetz, T. D. Miller, I. P. Clements, David Holmes, Raymond J Gibbons

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

This study sought to determine the prevalence of spontaneous reperfusion of an infarct-related artery (IRA) and associated myocardial salvage in the absence of thrombolysis or angioplasty. Twenty-one patients with acute myocardial infarction received only heparin and aspirin. At a median of 18 hours after presentation, 12 patients (57%) had angiographic patency of the IRA. Technetium-99m sestamibi was injected acutely on presentation and again at hospital discharge. Acute and final perfusion defect sizes were measured. Their difference, myocardial salvage, was calculated along with salvage index (myocardial salvage/acute defect). Comparing patients with a patent versus occluded IRA, myocardium at risk was similar (16% ± 12% vs 12% ± 9% left ventricle, p = NS); however, myocardial salvage (9% ± 9% vs -2% ± 7% left ventricle, p = 0.01), and salvage index (0.62 ± 0.37 vs 0.19 ± 0.33, p = 0.01) were greater in patients with spontaneous reperfusion. Resolution of chest pain was greater in patients with a patent IRA (100% vs 55%, p = 0.003). Spontaneous reperfusion of the IRA occurs frequently in patients with acute myocardial infarction and is associated with significant myocardial salvage.

Original languageEnglish (US)
Pages (from-to)421-427
Number of pages7
JournalAmerican Heart Journal
Volume135
Issue number3
DOIs
StatePublished - 1998

Fingerprint

Myocardial Reperfusion
Myocardial Infarction
Arteries
Reperfusion
Heart Ventricles
Technetium Tc 99m Sestamibi
Chest Pain
Angioplasty
Aspirin
Heparin
Myocardium
Perfusion

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Prevalence of spontaneous reperfusion and associated myocardial salvage in patients with acute myocardial infarction. / Christian, T. F.; Milavetz, J. J.; Miller, T. D.; Clements, I. P.; Holmes, David; Gibbons, Raymond J.

In: American Heart Journal, Vol. 135, No. 3, 1998, p. 421-427.

Research output: Contribution to journalArticle

@article{2f65aaab21354d718cb000940bb353fc,
title = "Prevalence of spontaneous reperfusion and associated myocardial salvage in patients with acute myocardial infarction",
abstract = "This study sought to determine the prevalence of spontaneous reperfusion of an infarct-related artery (IRA) and associated myocardial salvage in the absence of thrombolysis or angioplasty. Twenty-one patients with acute myocardial infarction received only heparin and aspirin. At a median of 18 hours after presentation, 12 patients (57{\%}) had angiographic patency of the IRA. Technetium-99m sestamibi was injected acutely on presentation and again at hospital discharge. Acute and final perfusion defect sizes were measured. Their difference, myocardial salvage, was calculated along with salvage index (myocardial salvage/acute defect). Comparing patients with a patent versus occluded IRA, myocardium at risk was similar (16{\%} ± 12{\%} vs 12{\%} ± 9{\%} left ventricle, p = NS); however, myocardial salvage (9{\%} ± 9{\%} vs -2{\%} ± 7{\%} left ventricle, p = 0.01), and salvage index (0.62 ± 0.37 vs 0.19 ± 0.33, p = 0.01) were greater in patients with spontaneous reperfusion. Resolution of chest pain was greater in patients with a patent IRA (100{\%} vs 55{\%}, p = 0.003). Spontaneous reperfusion of the IRA occurs frequently in patients with acute myocardial infarction and is associated with significant myocardial salvage.",
author = "Christian, {T. F.} and Milavetz, {J. J.} and Miller, {T. D.} and Clements, {I. P.} and David Holmes and Gibbons, {Raymond J}",
year = "1998",
doi = "10.1016/S0002-8703(98)70317-5",
language = "English (US)",
volume = "135",
pages = "421--427",
journal = "American Heart Journal",
issn = "0002-8703",
publisher = "Mosby Inc.",
number = "3",

}

TY - JOUR

T1 - Prevalence of spontaneous reperfusion and associated myocardial salvage in patients with acute myocardial infarction

AU - Christian, T. F.

AU - Milavetz, J. J.

AU - Miller, T. D.

AU - Clements, I. P.

AU - Holmes, David

AU - Gibbons, Raymond J

PY - 1998

Y1 - 1998

N2 - This study sought to determine the prevalence of spontaneous reperfusion of an infarct-related artery (IRA) and associated myocardial salvage in the absence of thrombolysis or angioplasty. Twenty-one patients with acute myocardial infarction received only heparin and aspirin. At a median of 18 hours after presentation, 12 patients (57%) had angiographic patency of the IRA. Technetium-99m sestamibi was injected acutely on presentation and again at hospital discharge. Acute and final perfusion defect sizes were measured. Their difference, myocardial salvage, was calculated along with salvage index (myocardial salvage/acute defect). Comparing patients with a patent versus occluded IRA, myocardium at risk was similar (16% ± 12% vs 12% ± 9% left ventricle, p = NS); however, myocardial salvage (9% ± 9% vs -2% ± 7% left ventricle, p = 0.01), and salvage index (0.62 ± 0.37 vs 0.19 ± 0.33, p = 0.01) were greater in patients with spontaneous reperfusion. Resolution of chest pain was greater in patients with a patent IRA (100% vs 55%, p = 0.003). Spontaneous reperfusion of the IRA occurs frequently in patients with acute myocardial infarction and is associated with significant myocardial salvage.

AB - This study sought to determine the prevalence of spontaneous reperfusion of an infarct-related artery (IRA) and associated myocardial salvage in the absence of thrombolysis or angioplasty. Twenty-one patients with acute myocardial infarction received only heparin and aspirin. At a median of 18 hours after presentation, 12 patients (57%) had angiographic patency of the IRA. Technetium-99m sestamibi was injected acutely on presentation and again at hospital discharge. Acute and final perfusion defect sizes were measured. Their difference, myocardial salvage, was calculated along with salvage index (myocardial salvage/acute defect). Comparing patients with a patent versus occluded IRA, myocardium at risk was similar (16% ± 12% vs 12% ± 9% left ventricle, p = NS); however, myocardial salvage (9% ± 9% vs -2% ± 7% left ventricle, p = 0.01), and salvage index (0.62 ± 0.37 vs 0.19 ± 0.33, p = 0.01) were greater in patients with spontaneous reperfusion. Resolution of chest pain was greater in patients with a patent IRA (100% vs 55%, p = 0.003). Spontaneous reperfusion of the IRA occurs frequently in patients with acute myocardial infarction and is associated with significant myocardial salvage.

UR - http://www.scopus.com/inward/record.url?scp=0031916110&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031916110&partnerID=8YFLogxK

U2 - 10.1016/S0002-8703(98)70317-5

DO - 10.1016/S0002-8703(98)70317-5

M3 - Article

VL - 135

SP - 421

EP - 427

JO - American Heart Journal

JF - American Heart Journal

SN - 0002-8703

IS - 3

ER -