Skip to main content

Prediction of enzymatic infarct size in ST-segment elevation myocardial infarction.

Publication ,  Journal Article
Mills, JS; Mahaffey, KW; Lokhnygina, Y; Nicolau, JC; Ruzyllo, W; Adams, PX; Todaro, TG; Armstrong, PW; Granger, CB; CARDINAL investigators,
Published in: Coron Artery Dis
March 2012

OBJECTIVES: 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.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Coron Artery Dis

DOI

EISSN

1473-5830

Publication Date

March 2012

Volume

23

Issue

2

Start / End Page

118 / 125

Location

England

Related Subject Headings

  • Treatment Outcome
  • Single-Chain Antibodies
  • Severity of Illness Index
  • Retrospective Studies
  • Prognosis
  • Myocardium
  • Myocardial Revascularization
  • Myocardial Infarction
  • Middle Aged
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Mills, J. S., Mahaffey, K. W., Lokhnygina, Y., Nicolau, J. C., Ruzyllo, W., Adams, P. X., … CARDINAL investigators, . (2012). Prediction of enzymatic infarct size in ST-segment elevation myocardial infarction. Coron Artery Dis, 23(2), 118–125. https://doi.org/10.1097/MCA.0b013e32834e4f8f
Mills, James S., Kenneth W. Mahaffey, Yuliya Lokhnygina, Jose C. Nicolau, Witold Ruzyllo, Peter X. Adams, Thomas G. Todaro, Paul W. Armstrong, Christopher B. Granger, and Christopher B. CARDINAL investigators. “Prediction of enzymatic infarct size in ST-segment elevation myocardial infarction.Coron Artery Dis 23, no. 2 (March 2012): 118–25. https://doi.org/10.1097/MCA.0b013e32834e4f8f.
Mills JS, Mahaffey KW, Lokhnygina Y, Nicolau JC, Ruzyllo W, Adams PX, et al. Prediction of enzymatic infarct size in ST-segment elevation myocardial infarction. Coron Artery Dis. 2012 Mar;23(2):118–25.
Mills, James S., et al. “Prediction of enzymatic infarct size in ST-segment elevation myocardial infarction.Coron Artery Dis, vol. 23, no. 2, Mar. 2012, pp. 118–25. Pubmed, doi:10.1097/MCA.0b013e32834e4f8f.
Mills JS, Mahaffey KW, Lokhnygina Y, Nicolau JC, Ruzyllo W, Adams PX, Todaro TG, Armstrong PW, Granger CB, CARDINAL investigators. Prediction of enzymatic infarct size in ST-segment elevation myocardial infarction. Coron Artery Dis. 2012 Mar;23(2):118–125.

Published In

Coron Artery Dis

DOI

EISSN

1473-5830

Publication Date

March 2012

Volume

23

Issue

2

Start / End Page

118 / 125

Location

England

Related Subject Headings

  • Treatment Outcome
  • Single-Chain Antibodies
  • Severity of Illness Index
  • Retrospective Studies
  • Prognosis
  • Myocardium
  • Myocardial Revascularization
  • Myocardial Infarction
  • Middle Aged
  • Male