TY - JOUR
T1 - Coronary anatomy and prognosis of young, asymptomatic survivors of myocardial infarction
AU - Negus, Brian H.
AU - Willard, John E.
AU - Glamann, D. Brent
AU - Landau, Charles
AU - Snyder, Richard W.
AU - Hillis, L. David
AU - Lange, Richard A.
PY - 1994
Y1 - 1994
N2 - purpose: To assess the coronary anatomy and prognosis of young, asymptomatic survivors of myocardial infarction. patients and methods: The records of all 5,316 patients who underwent cardiac catheterization at Parkland Memorial Hospital from July 1978 to December 1992 were reviewed to identify those patients 40 years old and younger who were catheterized within 60 days of a first myocardial infarction. Of 129 such patients, 48 had no indication for catheterization other than age (group I), and 81 were catheterized for spontaneous or provocable ischemia (group II). Extent of coronary artery disease and long-term follow-up were examined to ascertain the utility of cardiac catheterization in the asymptomatic patients. results: The 2 groups were similar with respect to clinical variables. The asymptomatic survivors of infarction (group I) had fewer diseased coronary arteries than did those with post-infarction ischemia (group II) (1.0 ± 0.7) versus 1.5 ± 1.0 [mean ± SD] diseased coronary arteries, respectively; P = 0.002 and were less likely to have left-main or 3-vessel coronary artery disease (4% versus 20%, respectively; P = 0.027). Eighty-three percent of the group I patients had one diseased coronary artery, or less, and no patient underwent angioplasty or coronary bypass grafting on the basis of catheterization. After 71 ± 44 months of follow-up, only 5 (10%) had died of a coronary-related event. conclusions: Asymptomatic survivors of myocardial infarction who are 40 years of age or less rarely have left-main or 3-vessel coronary artery disease, and their long-term prognosis with conservative therapy is good. Routine catheterization in these patients is not warranted and should be reserved for those who manifest spontaneous or provocable post-infarction ischemia.
AB - purpose: To assess the coronary anatomy and prognosis of young, asymptomatic survivors of myocardial infarction. patients and methods: The records of all 5,316 patients who underwent cardiac catheterization at Parkland Memorial Hospital from July 1978 to December 1992 were reviewed to identify those patients 40 years old and younger who were catheterized within 60 days of a first myocardial infarction. Of 129 such patients, 48 had no indication for catheterization other than age (group I), and 81 were catheterized for spontaneous or provocable ischemia (group II). Extent of coronary artery disease and long-term follow-up were examined to ascertain the utility of cardiac catheterization in the asymptomatic patients. results: The 2 groups were similar with respect to clinical variables. The asymptomatic survivors of infarction (group I) had fewer diseased coronary arteries than did those with post-infarction ischemia (group II) (1.0 ± 0.7) versus 1.5 ± 1.0 [mean ± SD] diseased coronary arteries, respectively; P = 0.002 and were less likely to have left-main or 3-vessel coronary artery disease (4% versus 20%, respectively; P = 0.027). Eighty-three percent of the group I patients had one diseased coronary artery, or less, and no patient underwent angioplasty or coronary bypass grafting on the basis of catheterization. After 71 ± 44 months of follow-up, only 5 (10%) had died of a coronary-related event. conclusions: Asymptomatic survivors of myocardial infarction who are 40 years of age or less rarely have left-main or 3-vessel coronary artery disease, and their long-term prognosis with conservative therapy is good. Routine catheterization in these patients is not warranted and should be reserved for those who manifest spontaneous or provocable post-infarction ischemia.
UR - http://www.scopus.com/inward/record.url?scp=0028220497&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0028220497&partnerID=8YFLogxK
U2 - 10.1016/0002-9343(94)90066-3
DO - 10.1016/0002-9343(94)90066-3
M3 - Article
C2 - 8166155
AN - SCOPUS:0028220497
SN - 0002-9343
VL - 96
SP - 354
EP - 358
JO - American Journal of Medicine
JF - American Journal of Medicine
IS - 4
ER -