Prognostic utility of comparative methods for assessment of ST-segment resolution after primary angioplasty for acute myocardial infarction: the Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC) trial
This study was done to assess and compare the prognostic significance of multiple methods for measuring ST-segment elevation resolution (STR) following primary percutaneous coronary intervention (PCI). Resolution of ST-segment elevation (STE) is a powerful predictor of both infarct-related artery pa...
Uloženo v:
| Vydáno v: | Journal of the American College of Cardiology Ročník 44; číslo 6; s. 1215 |
|---|---|
| Hlavní autoři: | , , , , , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
| Vydáno: |
United States
15.09.2004
|
| Témata: | |
| ISSN: | 0735-1097 |
| On-line přístup: | Zjistit podrobnosti o přístupu |
| Tagy: |
Přidat tag
Žádné tagy, Buďte první, kdo vytvoří štítek k tomuto záznamu!
|
| Abstract | This study was done to assess and compare the prognostic significance of multiple methods for measuring ST-segment elevation resolution (STR) following primary percutaneous coronary intervention (PCI).
Resolution of ST-segment elevation (STE) is a powerful predictor of both infarct-related artery patency and mortality in acute myocardial infarction (AMI). Recent thrombolytic studies have suggested that simple measures of STR may be as powerful as more complex algorithms. The optimal method of assessing STR following primary PCI has not been studied.
We analyzed 700 patients with technically adequate baseline and post-PCI electrocardiograms from the Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC) trial. Five methods were used to assess STR: 1) summed %STR across multiple leads (SigmaSTR); 2) %STR in the single lead with maximum baseline STE (MaxSTR); 3) absolute maximum STE before the procedure; 4) absolute maximum STE after intervention (MaxSTPost); and 5) a categorical variable based upon MaxSTPost (High Risk).
At 30 days, SigmaSTR, MaxSTR, and MaxSTPost all correlated strongly with mortality (p = 0.004, p = 0.005, and p < 0.0001, respectively) and the combined end point of mortality or reinfarction (p = 0.001, p = 0.001, and p < 0.0001). At one year, SigmaSTR and MaxSTPost correlated with mortality (p = 0.04, p = 0.0001), reinfarction (p = 0.02, p = 0.0015), and the combined end point (p = 0.02, p < 0.0001). By multivariate analysis, only the simpler measures of MaxSTPost and High Risk categorization independently predicted all outcomes at both time points.
The STR following primary PCI in AMI correlates strongly with mortality and reinfarction, independent of target vessel patency. The simple measure of the maximal residual degree of STE after primary PCI is a strong independent predictor of both survival and freedom from reinfarction at 30 days and 1 year. |
|---|---|
| AbstractList | This study was done to assess and compare the prognostic significance of multiple methods for measuring ST-segment elevation resolution (STR) following primary percutaneous coronary intervention (PCI).
Resolution of ST-segment elevation (STE) is a powerful predictor of both infarct-related artery patency and mortality in acute myocardial infarction (AMI). Recent thrombolytic studies have suggested that simple measures of STR may be as powerful as more complex algorithms. The optimal method of assessing STR following primary PCI has not been studied.
We analyzed 700 patients with technically adequate baseline and post-PCI electrocardiograms from the Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC) trial. Five methods were used to assess STR: 1) summed %STR across multiple leads (SigmaSTR); 2) %STR in the single lead with maximum baseline STE (MaxSTR); 3) absolute maximum STE before the procedure; 4) absolute maximum STE after intervention (MaxSTPost); and 5) a categorical variable based upon MaxSTPost (High Risk).
At 30 days, SigmaSTR, MaxSTR, and MaxSTPost all correlated strongly with mortality (p = 0.004, p = 0.005, and p < 0.0001, respectively) and the combined end point of mortality or reinfarction (p = 0.001, p = 0.001, and p < 0.0001). At one year, SigmaSTR and MaxSTPost correlated with mortality (p = 0.04, p = 0.0001), reinfarction (p = 0.02, p = 0.0015), and the combined end point (p = 0.02, p < 0.0001). By multivariate analysis, only the simpler measures of MaxSTPost and High Risk categorization independently predicted all outcomes at both time points.
The STR following primary PCI in AMI correlates strongly with mortality and reinfarction, independent of target vessel patency. The simple measure of the maximal residual degree of STE after primary PCI is a strong independent predictor of both survival and freedom from reinfarction at 30 days and 1 year. This study was done to assess and compare the prognostic significance of multiple methods for measuring ST-segment elevation resolution (STR) following primary percutaneous coronary intervention (PCI).OBJECTIVEThis study was done to assess and compare the prognostic significance of multiple methods for measuring ST-segment elevation resolution (STR) following primary percutaneous coronary intervention (PCI).Resolution of ST-segment elevation (STE) is a powerful predictor of both infarct-related artery patency and mortality in acute myocardial infarction (AMI). Recent thrombolytic studies have suggested that simple measures of STR may be as powerful as more complex algorithms. The optimal method of assessing STR following primary PCI has not been studied.BACKGROUNDResolution of ST-segment elevation (STE) is a powerful predictor of both infarct-related artery patency and mortality in acute myocardial infarction (AMI). Recent thrombolytic studies have suggested that simple measures of STR may be as powerful as more complex algorithms. The optimal method of assessing STR following primary PCI has not been studied.We analyzed 700 patients with technically adequate baseline and post-PCI electrocardiograms from the Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC) trial. Five methods were used to assess STR: 1) summed %STR across multiple leads (SigmaSTR); 2) %STR in the single lead with maximum baseline STE (MaxSTR); 3) absolute maximum STE before the procedure; 4) absolute maximum STE after intervention (MaxSTPost); and 5) a categorical variable based upon MaxSTPost (High Risk).METHODSWe analyzed 700 patients with technically adequate baseline and post-PCI electrocardiograms from the Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC) trial. Five methods were used to assess STR: 1) summed %STR across multiple leads (SigmaSTR); 2) %STR in the single lead with maximum baseline STE (MaxSTR); 3) absolute maximum STE before the procedure; 4) absolute maximum STE after intervention (MaxSTPost); and 5) a categorical variable based upon MaxSTPost (High Risk).At 30 days, SigmaSTR, MaxSTR, and MaxSTPost all correlated strongly with mortality (p = 0.004, p = 0.005, and p < 0.0001, respectively) and the combined end point of mortality or reinfarction (p = 0.001, p = 0.001, and p < 0.0001). At one year, SigmaSTR and MaxSTPost correlated with mortality (p = 0.04, p = 0.0001), reinfarction (p = 0.02, p = 0.0015), and the combined end point (p = 0.02, p < 0.0001). By multivariate analysis, only the simpler measures of MaxSTPost and High Risk categorization independently predicted all outcomes at both time points.RESULTSAt 30 days, SigmaSTR, MaxSTR, and MaxSTPost all correlated strongly with mortality (p = 0.004, p = 0.005, and p < 0.0001, respectively) and the combined end point of mortality or reinfarction (p = 0.001, p = 0.001, and p < 0.0001). At one year, SigmaSTR and MaxSTPost correlated with mortality (p = 0.04, p = 0.0001), reinfarction (p = 0.02, p = 0.0015), and the combined end point (p = 0.02, p < 0.0001). By multivariate analysis, only the simpler measures of MaxSTPost and High Risk categorization independently predicted all outcomes at both time points.The STR following primary PCI in AMI correlates strongly with mortality and reinfarction, independent of target vessel patency. The simple measure of the maximal residual degree of STE after primary PCI is a strong independent predictor of both survival and freedom from reinfarction at 30 days and 1 year.CONCLUSIONSThe STR following primary PCI in AMI correlates strongly with mortality and reinfarction, independent of target vessel patency. The simple measure of the maximal residual degree of STE after primary PCI is a strong independent predictor of both survival and freedom from reinfarction at 30 days and 1 year. |
| Author | Tcheng, James E Zimetbaum, Peter Turco, Mark Stuckey, Thomas Grines, Cindy L Cox, David A Stone, Gregg W Gardner, Graham Lansky, Alexandra J Aymong, Eve Guagliumi, Giulio McLaughlin, Michael G Garcia, Eulogio Josephson, Mark E Mehran, Roxana |
| Author_xml | – sequence: 1 givenname: Michael G surname: McLaughlin fullname: McLaughlin, Michael G organization: Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA – sequence: 2 givenname: Gregg W surname: Stone fullname: Stone, Gregg W – sequence: 3 givenname: Eve surname: Aymong fullname: Aymong, Eve – sequence: 4 givenname: Graham surname: Gardner fullname: Gardner, Graham – sequence: 5 givenname: Roxana surname: Mehran fullname: Mehran, Roxana – sequence: 6 givenname: Alexandra J surname: Lansky fullname: Lansky, Alexandra J – sequence: 7 givenname: Cindy L surname: Grines fullname: Grines, Cindy L – sequence: 8 givenname: James E surname: Tcheng fullname: Tcheng, James E – sequence: 9 givenname: David A surname: Cox fullname: Cox, David A – sequence: 10 givenname: Thomas surname: Stuckey fullname: Stuckey, Thomas – sequence: 11 givenname: Eulogio surname: Garcia fullname: Garcia, Eulogio – sequence: 12 givenname: Giulio surname: Guagliumi fullname: Guagliumi, Giulio – sequence: 13 givenname: Mark surname: Turco fullname: Turco, Mark – sequence: 14 givenname: Mark E surname: Josephson fullname: Josephson, Mark E – sequence: 15 givenname: Peter surname: Zimetbaum fullname: Zimetbaum, Peter |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/15364322$$D View this record in MEDLINE/PubMed |
| BookMark | eNpNkU-P0zAQxX1YxP6BL8ABzQnBIVkncZKGW5RloVKkXYnlXDnOuHXl2MV2uvSTc123FGlPo5He_N7Mm2tyYaxBQj5kNM1oVt1u0y0XIs0pZSmtUloWF-SK1kWZZLSpL8m191tKabXImrfkMiuLihV5fkX-Pjq7NtYHJWAOSqtwACtB2GnHHQ9qjzBh2NjRg7QOuPfo_YQmHFU_nxKP61Pn0FsdAdYAlwEd7JyauDsAN2tld5r7CD4RxBwi82AFd6PiGpSR3Inj5FcIG4TOmuCs1jhCOwj1J2KGSBnhDvdKICzNHuO6a34yCxZ6-xz9eh6x7SuzLp6glTjJPHzu2rtl37fdFwgu2r4jbyTXHt-f6w35df_tqfuR9A_fl13bJ5uC0pAUrBI0G3g9UCbrUlBRIyuHRnI5VjnLFnTMCyxLrKQUyBaCMSmO6RaNZM0w5jfk0z_uztnfc1x8NSkvUGtu0M5-VVWLmjasjsKPZ-E8TDiuzvmt_r8qfwES_Z5p |
| ContentType | Journal Article |
| CorporateAuthor | Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications trial |
| CorporateAuthor_xml | – name: Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications trial |
| DBID | CGR CUY CVF ECM EIF NPM 7X8 |
| DOI | 10.1016/j.jacc.2004.06.053 |
| DatabaseName | Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed MEDLINE - Academic |
| DatabaseTitle | MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) MEDLINE - Academic |
| DatabaseTitleList | MEDLINE MEDLINE - Academic |
| Database_xml | – sequence: 1 dbid: NPM name: PubMed url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: 7X8 name: MEDLINE - Academic url: https://search.proquest.com/medline sourceTypes: Aggregation Database |
| DeliveryMethod | no_fulltext_linktorsrc |
| Discipline | Medicine |
| ExternalDocumentID | 15364322 |
| Genre | Multicenter Study Comparative Study Clinical Trial Randomized Controlled Trial Journal Article |
| GroupedDBID | --- --K --M .55 .GJ .~1 0R~ 0SF 18M 1B1 1~. 1~5 29L 2WC 3O- 3V. 4.4 457 4G. 53G 5GY 5RE 5VS 6I. 6PF 7-5 71M 7RV 8P~ AABNK AACTN AAEDT AAEDW AAFTH AAIKJ AAKUH AAOAW AAQFI AAXUO AAYOK ABBQC ABFNM ABFRF ABLJU ABMAC ABOCM ABVKL ABWVN ABXDB ACGFO ACGFS ACIUM ACJTP ACPRK ACRPL ADBBV ADEZE ADMUD ADNMO ADVLN AEFWE AEKER AENEX AEXQZ AFCTW AFETI AFFNX AFRAH AFTJW AGHFR AGYEJ AHMBA AITUG AJOXV AJRQY AKRWK ALMA_UNASSIGNED_HOLDINGS AMFUW AMRAJ BAWUL BENPR BLXMC BPHCQ CGR CS3 CUY CVF DIK DU5 E3Z EBS ECM EIF EJD EO8 EO9 EP2 EP3 F5P FDB FEDTE FNPLU G-Q GX1 H13 HVGLF HZ~ IHE IXB J1W J5H K-O KQ8 L7B MO0 N4W N9A NCXOZ NPM O-L O9- OAUVE OK1 OZT P-9 P2P PC. PQQKQ PROAC Q38 QTD ROL RPZ SCC SDF SDG SDP SES SSZ T5K TR2 UNMZH UV1 W8F WH7 WOQ WOW X7M YYM YYP YZZ ZGI 7X8 ACVFH ADCNI AEUPX AFPUW AIGII AKBMS AKYEP EFKBS EFLBG ~HD |
| ID | FETCH-LOGICAL-h300t-346c01ba7b04f75c0c7e45b9fafd624180d23e55e6ffce48c44fc153639f49bd2 |
| IEDL.DBID | 7X8 |
| ISICitedReferencesCount | 162 |
| ISICitedReferencesURI | http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=000223937200010&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| ISSN | 0735-1097 |
| IngestDate | Thu Oct 02 09:26:51 EDT 2025 Wed Feb 19 01:39:54 EST 2025 |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 6 |
| Language | English |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-h300t-346c01ba7b04f75c0c7e45b9fafd624180d23e55e6ffce48c44fc153639f49bd2 |
| Notes | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Undefined-3 |
| PMID | 15364322 |
| PQID | 66870947 |
| PQPubID | 23479 |
| ParticipantIDs | proquest_miscellaneous_66870947 pubmed_primary_15364322 |
| PublicationCentury | 2000 |
| PublicationDate | 2004-09-15 |
| PublicationDateYYYYMMDD | 2004-09-15 |
| PublicationDate_xml | – month: 09 year: 2004 text: 2004-09-15 day: 15 |
| PublicationDecade | 2000 |
| PublicationPlace | United States |
| PublicationPlace_xml | – name: United States |
| PublicationTitle | Journal of the American College of Cardiology |
| PublicationTitleAlternate | J Am Coll Cardiol |
| PublicationYear | 2004 |
| SSID | ssj0006819 |
| Score | 2.2445133 |
| Snippet | This study was done to assess and compare the prognostic significance of multiple methods for measuring ST-segment elevation resolution (STR) following primary... |
| SourceID | proquest pubmed |
| SourceType | Aggregation Database Index Database |
| StartPage | 1215 |
| SubjectTerms | Aged Angioplasty, Balloon, Coronary Coronary Angiography Coronary Circulation - physiology Electrocardiography Female Heart Conduction System - pathology Heart Conduction System - physiopathology Humans Male Middle Aged Multivariate Analysis Myocardial Infarction - epidemiology Myocardial Infarction - physiopathology Myocardial Infarction - therapy Postoperative Complications - diagnosis Postoperative Complications - epidemiology Postoperative Complications - etiology Predictive Value of Tests Prognosis Prospective Studies Recurrence Risk Factors Statistics as Topic Survival Analysis Treatment Outcome |
| Title | Prognostic utility of comparative methods for assessment of ST-segment resolution after primary angioplasty for acute myocardial infarction: the Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC) trial |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/15364322 https://www.proquest.com/docview/66870947 |
| Volume | 44 |
| WOSCitedRecordID | wos000223937200010&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| hasFullText | |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| link | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV1Nb9QwELUKRagXKN8tFObAAQ4WTuM4cYWEVttWIKWrlSjS3laJPS6LqmTb3SL45VyZcbJ0L1UPXCJFccZR_DJ5icfvCfE2aO9DnlnJ8ldSB4PSuiyRGILJfOIVmrhQuMxHo2IyseMN8XG1FobLKlc5MSZq3zr-R_7BGEKW1fmn-YVkzyieW-0NNO6IzZSIDGM6n1xrhZsi2noQhllr0-b9kpmuuutH5aKAoY7qnWyNfBPBjC-a44f_d4nb4kFPMGHQIeKR2MDmsbh_0k-hPxF_xpctF9fRYSDQMQuHNoC7VgGHzlV6AcRnofqn3Mmtvp7KBZ7FPfpM71EL0Wcc5p1uBVTN2aydEymnwDGCu1pSzN_00mQwngNhmp4uPvMAiH7CsKuWP0cPg9rNflGYmqJ4OEROY7AmBUKdLVso2dkNSmLJMFjrbLheHQ_vCGNfynIwfA_RmeSp-HZ8dDr8LHv3B_k9VWopU22cSuoqr5UmNDnlctRZbUMVvCHeUSi_n2KWoQnBoS6c1sFR_ibKFbSt_f4zcbdpG3whQBc1emUx8dRQZ1i4QoU8ZS5cpJXTO-LNakCn9HTxlEnVYHu1mK6GdEc87zAx7W_mlHvSlA13bz33pdjqyn2sTLJXYjNQXsE9cc_9XM4Wl68jaGk7Gp_8Bd3R_s8 |
| linkProvider | ProQuest |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Prognostic+utility+of+comparative+methods+for+assessment+of+ST-segment+resolution+after+primary+angioplasty+for+acute+myocardial+infarction%3A+the+Controlled+Abciximab+and+Device+Investigation+to+Lower+Late+Angioplasty+Complications+%28CADILLAC%29+trial&rft.jtitle=Journal+of+the+American+College+of+Cardiology&rft.au=McLaughlin%2C+Michael+G&rft.au=Stone%2C+Gregg+W&rft.au=Aymong%2C+Eve&rft.au=Gardner%2C+Graham&rft.date=2004-09-15&rft.issn=0735-1097&rft.volume=44&rft.issue=6&rft.spage=1215&rft_id=info:doi/10.1016%2Fj.jacc.2004.06.053&rft_id=info%3Apmid%2F15364322&rft_id=info%3Apmid%2F15364322&rft.externalDocID=15364322 |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0735-1097&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0735-1097&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0735-1097&client=summon |