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Size of Anterior Wall Acute Myocardial Infarction Treated by Primary Percutaneous Coronary Intervention in United States Versus Europe/Australia Versus India (from the CRISP-AMI Randomized Controlled Trial).

Publication ,  Journal Article
Marquis-Gravel, G; Thiele, H; Jones, WS; Smalling, RW; Cohen, M; Perera, D; Pijls, N; Fanaroff, A; Brucker, A; Chiswell, K; Patel, MR; Ohman, EM
Published in: Am J Cardiol
April 1, 2019

International variability in infarct size following acute anterior ST-elevation myocardial infarction without shock treated with primary percutaneous coronary intervention (PCI) has been little studied. Patients enrolled in the Counterpulsation to Reduce Infarct Size pre-PCI for Acute Myocardial Infarction international randomized trial were analyzed according to their region of enrollment: United States (US) (n = 60), Europe/Australia (EU/AU) (n = 104), or India (n = 123). Cardiac magnetic resonance imaging was performed 3-5 days after PCI to assess infarct size, expressed as percentage of left ventricular mass, and analyzed by an imaging core laboratory. The relation between infarct size and region was modelled using multivariable linear regression adjusting for time from symptom onset to first hospital contact, myocardial infarction severity, and baseline characteristics. Infarct size was 36.4% of left ventricular mass in US patients (95% confidence interval [CI] 31.5 to 41.4), 36.5% (95% CI 32.6 to 40.4) in EU/AU patients, and 44.7% (95% CI 41.1 to 48.2) in patients from India (p = 0.01). In multiplicity-adjusted regression analysis, mean infarct size in patients from India was higher than in US patients (mean difference of 8.3%; 95% CI 0.7 to 15.8; p = 0.03), and EU/AU patients (mean difference of 8.2%; 95% CI 1.6 to 14.8; p = 0.01). There was no significance difference in infarct size between patients from the EU/AU and the US (mean difference of 0.1%; 95% CI -7.5 to 7.4; p = 0.99). ln conclusion, in patients with anterior ST-elevation myocardial infarction without cardiogenic shock treated with primary PCI, infarct size was larger in India compared to the United States and EU/AU, even after adjustment for performance metrics, including time to treatment, and other potential confounders. Future studies are needed to better elucidate this discrepancy.

Duke Scholars

Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

April 1, 2019

Volume

123

Issue

7

Start / End Page

1026 / 1034

Location

United States

Related Subject Headings

  • United States
  • Survival Rate
  • Severity of Illness Index
  • Retrospective Studies
  • Prognosis
  • Percutaneous Coronary Intervention
  • Myocardium
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging, Cine
 

Citation

APA
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ICMJE
MLA
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Marquis-Gravel, G., Thiele, H., Jones, W. S., Smalling, R. W., Cohen, M., Perera, D., … Ohman, E. M. (2019). Size of Anterior Wall Acute Myocardial Infarction Treated by Primary Percutaneous Coronary Intervention in United States Versus Europe/Australia Versus India (from the CRISP-AMI Randomized Controlled Trial). Am J Cardiol, 123(7), 1026–1034. https://doi.org/10.1016/j.amjcard.2018.12.027
Marquis-Gravel, Guillaume, Holger Thiele, W Schuyler Jones, Richard W. Smalling, Marc Cohen, Divaka Perera, Nico Pijls, et al. “Size of Anterior Wall Acute Myocardial Infarction Treated by Primary Percutaneous Coronary Intervention in United States Versus Europe/Australia Versus India (from the CRISP-AMI Randomized Controlled Trial).Am J Cardiol 123, no. 7 (April 1, 2019): 1026–34. https://doi.org/10.1016/j.amjcard.2018.12.027.
Marquis-Gravel, Guillaume, et al. “Size of Anterior Wall Acute Myocardial Infarction Treated by Primary Percutaneous Coronary Intervention in United States Versus Europe/Australia Versus India (from the CRISP-AMI Randomized Controlled Trial).Am J Cardiol, vol. 123, no. 7, Apr. 2019, pp. 1026–34. Pubmed, doi:10.1016/j.amjcard.2018.12.027.
Marquis-Gravel G, Thiele H, Jones WS, Smalling RW, Cohen M, Perera D, Pijls N, Fanaroff A, Brucker A, Chiswell K, Patel MR, Ohman EM. Size of Anterior Wall Acute Myocardial Infarction Treated by Primary Percutaneous Coronary Intervention in United States Versus Europe/Australia Versus India (from the CRISP-AMI Randomized Controlled Trial). Am J Cardiol. 2019 Apr 1;123(7):1026–1034.
Journal cover image

Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

April 1, 2019

Volume

123

Issue

7

Start / End Page

1026 / 1034

Location

United States

Related Subject Headings

  • United States
  • Survival Rate
  • Severity of Illness Index
  • Retrospective Studies
  • Prognosis
  • Percutaneous Coronary Intervention
  • Myocardium
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging, Cine