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Unraveling the spec...
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Al-Faleh, Hussam
(författare)
Unraveling the spectrum of left bundle branch block in acute myocardial infarction : insights from the Assessment of the Safety and Efficacy of a New Thrombolytic (ASSENT 2 and 3) trials
- Artikel/kapitelEngelska2006
Förlag, utgivningsår, omfång ...
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Elsevier BV,2006
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printrdacarrier
Nummerbeteckningar
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LIBRIS-ID:oai:DiVA.org:uu-24435
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-24435URI
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https://doi.org/10.1016/j.ahj.2005.02.043DOI
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Språk:engelska
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Sammanfattning på:engelska
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Ämneskategori:ref swepub-contenttype
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Ämneskategori:art swepub-publicationtype
Anmärkningar
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BACKGROUND: Left bundle branch block (LBBB) complicates the diagnosis of acute myocardial infarction (AMI). The Sgarbossa criteria were developed from GUSTO I to surmount this diagnostic challenge but have not been prospectively validated in a large population with presumed AMI. We evaluated their utility in the diagnosis and risk stratification of AMI patients in ASSENT 2 & 3. METHODS: Baseline electrocardiograms (ECG) of LBBB patients were scored using Sgarbossa's criteria (0-10) by 2 readers blinded to the CK/CK-MB data and clinical outcomes; 267 (1.2%) patients had LBBB on their baseline ECG. RESULTS: Among 253 LBBB patients with available peak CK/CK-MB data, 158 (62.5%) had peak CK/CK-MB levels > 2x ULN, thereby qualifying for the diagnosis of AMI. A Sgarbossa score of 3 was shown in 48.7% of LBBB patients with elevated CK/CK-MB versus in 12.6% of those without a CK/CK-MB rise (P < .001). Patients with higher Sgarbossa scores, ie, 3, had a higher mortality compared with those with a score < 3, (23.5% vs 7.7% at 30 days P < .001; and 33.7% vs 20.2% at 1 year, P < .001, respectively). CONCLUSIONS: Our findings validate the utility of Sgarbossa criteria for diagnosing AMI in the setting of LBBB. These criteria provide a simple and practical diagnostic approach to risk stratify this diagnostically challenging high-risk group and optimize risk-benefit of acute therapy.
Ämnesord och genrebeteckningar
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Aged
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Bundle-Branch Block/*complications
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Clinical Trials
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Electrocardiography/methods
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Female
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Humans
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Male
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Middle Aged
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Myocardial Infarction/*complications/*diagnosis
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Prognosis
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Risk Assessment
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MEDICINE
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MEDICIN
Biuppslag (personer, institutioner, konferenser, titlar ...)
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Fu, Yuling
(författare)
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Wagner, Galen
(författare)
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Goodman, Shaun
(författare)
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Sgarbossa, Elena
(författare)
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Granger, Christopher
(författare)
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Van de Werf, Frans
(författare)
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Wallentin, Lars,1943-Uppsala universitet,Institutionen för medicinska vetenskaper,UCR(Swepub:uu)larswall
(författare)
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Armstrong, Paul W.
(författare)
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Uppsala universitetInstitutionen för medicinska vetenskaper
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:American Heart Journal: Elsevier BV151:1, s. 10-50002-87031097-6744
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Al-Faleh, Hussam
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Fu, Yuling
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Wagner, Galen
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Goodman, Shaun
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Sgarbossa, Elena
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Granger, Christo ...
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Van de Werf, Fra ...
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Wallentin, Lars, ...
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Armstrong, Paul ...
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- Artiklar i publikationen
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American Heart J ...
- Av lärosätet
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Uppsala universitet