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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP-
dc.contributor.authorMILLS, James S.-
dc.contributor.authorMAHAFFEY, Kenneth W.-
dc.contributor.authorLOKHNYGINA, Yuliya-
dc.contributor.authorNICOLAU, Jose C.-
dc.contributor.authorRUZYLLO, Witold-
dc.contributor.authorADAMS, Peter X.-
dc.contributor.authorTODARO, Thomas G.-
dc.contributor.authorARMSTRONG, Paul W.-
dc.contributor.authorGRANGER, Christopher B.-
dc.identifier.citationCORONARY ARTERY DISEASE, v.23, n.2, p.118-125, 2012-
dc.description.abstractObjectives Predictors of adverse outcomes following myocardial infarction (MI) are well established; however, little is known about what predicts enzymatically estimated infarct size in patients with acute ST-elevation MI. The Complement And Reduction of INfarct size after Angioplasty or Lytics trials of pexelizumab used creatine kinase (CK)-MB area under the curve to determine infarct size in patients treated with primary percutaneous coronary intervention (PCI) or fibrinolysis. Methods Prediction of infarct size was carried out by measuring CK-MB area under the curve in patients with ST-segment elevation MI treated with reperfusion therapy from January 2000 to April 2002. Infarct size was calculated in 1622 patients (PCI=817; fibrinolysis=805). Logistic regression was used to examine the relationship between baseline demographics, total ST-segment elevation, index angiographic findings (PCI group), and binary outcome of CK-MB area under the curve greater than 3000 ng/ml. Results Large infarcts occurred in 63% (515) of the PCI group and 69% (554) of the fibrinolysis group. Independent predictors of large infarcts differed depending on mode of reperfusion. In PCI, male sex, no prior coronary revascularization and diabetes, decreased systolic blood pressure, sum of ST-segment elevation, total (angiographic) occlusion, and nonright coronary artery culprit artery were independent predictors of larger infarcts (C index=0.73). In fibrinolysis, younger age, decreased heart rate, white race, no history of arrhythmia, increased time to fibrinolytic therapy in patients treated up to 2 h after symptom onset, and sum of ST-segment elevation were independently associated with a larger infarct size (C index=0.68). Conclusion Clinical and patient data can be used to predict larger infarcts on the basis of CK-MB quantification. These models may be helpful in designing future trials and in guiding the use of novel pharmacotherapies aimed at limiting infarct size in clinical practice. Coron Artery Dis 23:118-125 (C) 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.-
dc.description.sponsorshipProcter & Gamble Pharmaceuticals (Mason, Ohio, USA)-
dc.description.sponsorshipAlexion Pharmaceuticals Inc. (Cheshire, Connecticut, USA)-
dc.description.sponsorshipProcter & Gamble Pharmaceuticals-
dc.description.sponsorshipAlexion Pharmaceuticals Inc.-
dc.relation.ispartofCoronary Artery Disease-
dc.subjectcardiac biomarkers-
dc.subjectcreatine kinase-
dc.subjectinfarct size-
dc.subjectmyocardial infarction-
dc.subjectST-segment elevation myocardial infarction-
dc.subject.otheracute coronary syndromes-
dc.subject.othertissue-plasminogen activator-
dc.subject.otheranti-c5 complement antibody-
dc.subject.otherthrombolytic therapy-
dc.subject.otherintravenous streptokinase-
dc.subject.otherinternational trial-
dc.subject.otheradjunctive therapy-
dc.titlePrediction of enzymatic infarct size in ST-segment elevation myocardial infarction-
dc.rights.holderCopyright LIPPINCOTT WILLIAMS & WILKINS-
dc.contributor.groupauthorCARDINAL Investigators-
dc.subject.wosPeripheral Vascular Disease-
dc.type.categoryoriginal article-
dc.type.versionpublishedVersion-, James S.:Duke Univ, Med Ctr, Duke Clin Res Inst, Durham, NC 27609 USA-, Witold:Natl Inst Cardiol, Warsaw, Poland-, Peter X.:Mesoblast Ltd, New York, NY USA-, Thomas G.:Medpace, Cincinnati, OH USA-, Paul W.:Univ Alberta, Edmonton, AB, Canada-
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Appears in Collections:

Artigos e Materiais de Revistas Científicas - FM/MCP
Departamento de Cardio-Pneumologia - FM/MCP

Artigos e Materiais de Revistas Científicas - HC/InCor
Instituto do Coração - HC/InCor

Artigos e Materiais de Revistas Científicas - LIM/11
LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação

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