Complete atrioventricular block complicating inferior wall acute myocardial infarction treated with reperfusion therapy
dc.contributor.author | Clemmensen, Peter | en_US |
dc.contributor.author | Bates, Eric R. | en_US |
dc.contributor.author | Califf, Robert M. | en_US |
dc.contributor.author | Hlatky, Mark A. | en_US |
dc.contributor.author | Aronson, Lynn G. | en_US |
dc.contributor.author | George, Barry S. | en_US |
dc.contributor.author | Lee, Kerry L. | en_US |
dc.contributor.author | Kereiakes, Dean J. | en_US |
dc.contributor.author | Gacioch, Gerald M. | en_US |
dc.contributor.author | Berrios, Eric | en_US |
dc.date.accessioned | 2006-04-10T14:49:24Z | |
dc.date.available | 2006-04-10T14:49:24Z | |
dc.date.issued | 1991-02-01 | en_US |
dc.identifier.citation | Clemmensen, Peter, Bates, Eric R., Califf, Robert M., Hlatky, Mark A., Aronson, Lynne, George, Barry S., Lee, Kerry L., Kereiakes, Dean J., Gacioch, Gerald, Berrios, Eric (1991/02/01)."Complete atrioventricular block complicating inferior wall acute myocardial infarction treated with reperfusion therapy." The American Journal of Cardiology 67(4): 225-230. <http://hdl.handle.net/2027.42/29481> | en_US |
dc.identifier.uri | http://www.sciencedirect.com/science/article/B6T10-4C76BSF-8J/2/6ef341f8c39008aa16a13e485b450663 | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/29481 | |
dc.identifier.uri | http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=1899319&dopt=citation | en_US |
dc.description.abstract | Previous studies report larger myocardial infants and increased in-hospital mortality rates in patients with inferior wall acute myocardial infarction (AMI) and complete atrioventricular block (AV), but the clinical implications of these complications in patients treated with reperfusion therapy have not been addressed. The clinical course of 373 patients--50 (13%) of whom developed complete AV block--admitted with inferior wall AMI and given thrombolytic therapy within 6 hours of symptom onset was studied. Acute patency rates of the infarct artery after thrombolytic therapy were similar in patients with or without AV block. Ventricular function measured at baseline and before discharge in patients with complete AV block showed a decrement in median ejection fraction (-3.5 vs -0.4%, P = 0.03) and in median regional wall motion (-0.14 vs +0.24 standard deviations/chord, P = 0.05). The reocclusion rate was higher in patients with complete AV block (29 vs 16%, P = 0.03). Patients with complete AV block had more episodes of ventricular fibrillation or tachycardia (36 vs 14%, p < 0.001), sustained hypotension (36 vs 10%, p < 0.001), pulmonary edema (12 vs 4%, P = 0.02) and a higher in-hospital mortality rate (20 vs 4%, p < 0.001), although the mortality rate after hospital discharge was identical (2%) in the 2 groups. Multivariable logistic regression analysis revealed that complete AV block was a strong independent predictor of in-hospital mortality (p = 0.0006). Thus, despite initial successful reperfusion, patients with inferior wall AMI and complete AV block have higher rates of in-hospital complications and mortality. | en_US |
dc.format.extent | 1047109 bytes | |
dc.format.extent | 3118 bytes | |
dc.format.mimetype | application/pdf | |
dc.format.mimetype | text/plain | |
dc.language.iso | en_US | |
dc.publisher | Elsevier | en_US |
dc.title | Complete atrioventricular block complicating inferior wall acute myocardial infarction treated with reperfusion therapy | en_US |
dc.type | Article | en_US |
dc.rights.robots | IndexNoFollow | en_US |
dc.subject.hlbsecondlevel | Internal Medicine and Specialties | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.description.peerreviewed | Peer Reviewed | en_US |
dc.contributor.affiliationum | Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, U.S.A.; The Riverside Methodist Hospital, Columbus, Ohio, U.S.A.; Christ Hospital, Cincinnati, Ohio, U.S.A.; Division of Cardiology, Department of Medicine, Duke University, Durham, North Carolina, U.S.A. | en_US |
dc.contributor.affiliationum | Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, U.S.A.; The Riverside Methodist Hospital, Columbus, Ohio, U.S.A.; Christ Hospital, Cincinnati, Ohio, U.S.A.; Division of Cardiology, Department of Medicine, Duke University, Durham, North Carolina, U.S.A. | en_US |
dc.contributor.affiliationum | Division of Cardiology, Department of Medicine, Duke University, Durham, North Carolina, U.S.A.; Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, U.S.A.; The Riverside Methodist Hospital, Columbus, Ohio, U.S.A.; Christ Hospital, Cincinnati, Ohio, U.S.A. | en_US |
dc.contributor.affiliationum | Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, U.S.A.; The Riverside Methodist Hospital, Columbus, Ohio, U.S.A.; Christ Hospital, Cincinnati, Ohio, U.S.A.; Division of Cardiology, Department of Medicine, Duke University, Durham, North Carolina, U.S.A. | en_US |
dc.contributor.affiliationum | Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, U.S.A.; The Riverside Methodist Hospital, Columbus, Ohio, U.S.A.; Christ Hospital, Cincinnati, Ohio, U.S.A.; Division of Cardiology, Department of Medicine, Duke University, Durham, North Carolina, U.S.A. | en_US |
dc.contributor.affiliationum | Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, U.S.A.; The Riverside Methodist Hospital, Columbus, Ohio, U.S.A.; Christ Hospital, Cincinnati, Ohio, U.S.A.; Division of Cardiology, Department of Medicine, Duke University, Durham, North Carolina, U.S.A. | en_US |
dc.contributor.affiliationum | Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, U.S.A.; The Riverside Methodist Hospital, Columbus, Ohio, U.S.A.; Christ Hospital, Cincinnati, Ohio, U.S.A.; Division of Cardiology, Department of Medicine, Duke University, Durham, North Carolina, U.S.A. | en_US |
dc.contributor.affiliationum | Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, U.S.A.; The Riverside Methodist Hospital, Columbus, Ohio, U.S.A.; Christ Hospital, Cincinnati, Ohio, U.S.A.; Division of Cardiology, Department of Medicine, Duke University, Durham, North Carolina, U.S.A. | en_US |
dc.contributor.affiliationum | Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, U.S.A.; The Riverside Methodist Hospital, Columbus, Ohio, U.S.A.; Christ Hospital, Cincinnati, Ohio, U.S.A. | en_US |
dc.contributor.affiliationum | Division of Cardiology, Department of Medicine, Duke University, Durham, North Carolina, U.S.A.; Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, U.S.A.; The Riverside Methodist Hospital, Columbus, Ohio, U.S.A.; Christ Hospital, Cincinnati, Ohio, U.S.A. | en_US |
dc.identifier.pmid | 1899319 | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/29481/1/0000567.pdf | en_US |
dc.identifier.doi | http://dx.doi.org/10.1016/0002-9149(91)90550-5 | en_US |
dc.identifier.source | The American Journal of Cardiology | en_US |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
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