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A dynamic model forecasting myocardial infarct size before, during, and after reperfusion therapy: an ASSENT-2 ECG/VCG substudy
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- Johanson, Per, 1963 (författare)
- Gothenburg University,Göteborgs universitet,Hjärt-kärlinstitutionen,Cardiovascular Institute
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Fu, Y. (författare)
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Goodman, S. G. (författare)
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- Dellborg, Mikael, 1954 (författare)
- Gothenburg University,Göteborgs universitet,Hjärt-kärlinstitutionen,Cardiovascular Institute
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Armstrong, P. W. (författare)
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Krucoff, M. W. (författare)
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- Wallentin, Lars (författare)
- Uppsala universitet,Institutionen för medicinska vetenskaper
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Wagner, G. S. (författare)
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(creator_code:org_t)
- 2005-04-11
- Engelska.
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Ingår i: Eur Heart J. - : Oxford University Press (OUP). - 0195-668X. ; 26:17, s. 1726-33
- Relaterad länk:
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https://academic.oup...
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http://www.ncbi.nlm....
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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Abstract
Ämnesord
Stäng
- AIMS: Serial forecasts of final myocardial infarct (MI) size during fibrinolytic treatment (Rx) of ST-elevation MI would allow the identification of high-risk patients with a predicted major loss of viable myocardium, at a point when treatment may still be modified. We investigated a model for such forecasting, using time and the ECG. METHODS AND RESULTS: We collected 234 patients with ST-elevation MI, without signs of previous MI, bundle branch block, or hypertrophy. MI size was determined by the Selvester score and was "forecasted" at: admission with patients stratified by delay time and an ECG acuteness score into three groups (EARLY, DISCORDANT, and LATE); 90 min after Rx by > or =70% ST-recovery or not and occurrence of "reperfusion peaks"; 4 h after Rx by ST re-elevations. EARLY patients had smaller final infarct sizes than LATE (9.4 vs. 20%, P=0.01). EARLY patients with > or =70% ST-recovery without a reperfusion peak had smaller infarct sizes than those with (3.1 vs. 12.5%, P=0.001). EARLY patients without ST re-elevations had smaller infarct sizes (1.5%) than those with some (9%) or many re-elevations (12%), P<0.001. CONCLUSION: Final infarct size can be forecasted using delay time and serial ECGs. Serially updated forecasts seem especially important when both clock-time and initial ECG- signs indicate earliness.
Nyckelord
- Aged
- Electrocardiography
- Female
- Humans
- Logistic Models
- Male
- Middle Aged
- *Models
- Cardiovascular
- Myocardial Infarction/*drug therapy/*pathology/physiopathology
- Prognosis
- Severity of Illness Index
- *Thrombolytic Therapy
- Time Factors
- Vectorcardiography
- Aged
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)