Significance of left circumflex artery-related acute myocardial infarction without ST-T changes

Su Kiat Chua, Kou Gi Shyu, Jun Jack Cheng, Jer Young Liou, Sheng Chang Lin, Huei Fong Hung, Shih Huang Lee, Chiung Zuan Chiu, Huey Ming Lo

Research output: Contribution to journalArticle

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Abstract

Introduction: Left circumflex (LC)-related acute myocardial infarction (AMI) presenting without ST-T changes has been underdiagnosed in the emergency department. There is little information on its clinical features and significance. Aims: The aims of the study were to investigate the clinical characteristics and outcomes of LC-related AMI without ST-T changes. Population and Methods: Ninety-six patients were admitted for LC-related AMI. Comparisons between those with and without ST-T changes were analyzed. Results: Twenty-two patients (23%) did not have ST-T changes, whereas 74 patients (77%) had them. Patients without ST-T changes had younger age (55.6 ± 16.8 vs 62.6 ± 12.0 years, P = .03), fewer presented as Killip III/IV (4.5% vs 27.4%, P = .02) and with lower creatine kinase (1647.3 ± 1602.2 vs 2778.2 ± 2343.3 IU/L, P = .037) and creatine kinase-MB (136.8 ± 130.3 vs 247.7 ± 200.0 IU/L, P = .017), and more were with concurrent culprit lesion in the middle or distal LC and right- or balanced-dominant coronary circulation (86.4% vs 44.6%, P <.001). During follow-up, the need for repeat percutaneous coronary intervention (48.6% vs 45.5%, P = .40) and recurrent infarction (13.5% vs 13.6%, P = .62) were similar between the 2 groups. The 30-day mortality (0% vs 5.4%, P = .35) and overall mortality rate (4.5% vs 12.2%, P = .28) between them were not different statistically. Conclusion: The relatively lower prevalence of LC-related AMI without ST-T changes in the study might be underestimated. These patients have smaller infarct size than patients with ST-T changes without differences in the short- and long-term outcomes between them.

Original languageEnglish
Pages (from-to)183-188
Number of pages6
JournalAmerican Journal of Emergency Medicine
Volume28
Issue number2
DOIs
Publication statusPublished - Feb 2010

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Arteries
Myocardial Infarction
MB Form Creatine Kinase
Coronary Circulation
Mortality
Percutaneous Coronary Intervention
Creatine Kinase
Infarction
Hospital Emergency Service
Population

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Chua, S. K., Shyu, K. G., Cheng, J. J., Liou, J. Y., Lin, S. C., Hung, H. F., ... Lo, H. M. (2010). Significance of left circumflex artery-related acute myocardial infarction without ST-T changes. American Journal of Emergency Medicine, 28(2), 183-188. https://doi.org/10.1016/j.ajem.2008.11.010

Significance of left circumflex artery-related acute myocardial infarction without ST-T changes. / Chua, Su Kiat; Shyu, Kou Gi; Cheng, Jun Jack; Liou, Jer Young; Lin, Sheng Chang; Hung, Huei Fong; Lee, Shih Huang; Chiu, Chiung Zuan; Lo, Huey Ming.

In: American Journal of Emergency Medicine, Vol. 28, No. 2, 02.2010, p. 183-188.

Research output: Contribution to journalArticle

Chua, SK, Shyu, KG, Cheng, JJ, Liou, JY, Lin, SC, Hung, HF, Lee, SH, Chiu, CZ & Lo, HM 2010, 'Significance of left circumflex artery-related acute myocardial infarction without ST-T changes', American Journal of Emergency Medicine, vol. 28, no. 2, pp. 183-188. https://doi.org/10.1016/j.ajem.2008.11.010
Chua, Su Kiat ; Shyu, Kou Gi ; Cheng, Jun Jack ; Liou, Jer Young ; Lin, Sheng Chang ; Hung, Huei Fong ; Lee, Shih Huang ; Chiu, Chiung Zuan ; Lo, Huey Ming. / Significance of left circumflex artery-related acute myocardial infarction without ST-T changes. In: American Journal of Emergency Medicine. 2010 ; Vol. 28, No. 2. pp. 183-188.
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abstract = "Introduction: Left circumflex (LC)-related acute myocardial infarction (AMI) presenting without ST-T changes has been underdiagnosed in the emergency department. There is little information on its clinical features and significance. Aims: The aims of the study were to investigate the clinical characteristics and outcomes of LC-related AMI without ST-T changes. Population and Methods: Ninety-six patients were admitted for LC-related AMI. Comparisons between those with and without ST-T changes were analyzed. Results: Twenty-two patients (23{\%}) did not have ST-T changes, whereas 74 patients (77{\%}) had them. Patients without ST-T changes had younger age (55.6 ± 16.8 vs 62.6 ± 12.0 years, P = .03), fewer presented as Killip III/IV (4.5{\%} vs 27.4{\%}, P = .02) and with lower creatine kinase (1647.3 ± 1602.2 vs 2778.2 ± 2343.3 IU/L, P = .037) and creatine kinase-MB (136.8 ± 130.3 vs 247.7 ± 200.0 IU/L, P = .017), and more were with concurrent culprit lesion in the middle or distal LC and right- or balanced-dominant coronary circulation (86.4{\%} vs 44.6{\%}, P <.001). During follow-up, the need for repeat percutaneous coronary intervention (48.6{\%} vs 45.5{\%}, P = .40) and recurrent infarction (13.5{\%} vs 13.6{\%}, P = .62) were similar between the 2 groups. The 30-day mortality (0{\%} vs 5.4{\%}, P = .35) and overall mortality rate (4.5{\%} vs 12.2{\%}, P = .28) between them were not different statistically. Conclusion: The relatively lower prevalence of LC-related AMI without ST-T changes in the study might be underestimated. These patients have smaller infarct size than patients with ST-T changes without differences in the short- and long-term outcomes between them.",
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T1 - Significance of left circumflex artery-related acute myocardial infarction without ST-T changes

AU - Chua, Su Kiat

AU - Shyu, Kou Gi

AU - Cheng, Jun Jack

AU - Liou, Jer Young

AU - Lin, Sheng Chang

AU - Hung, Huei Fong

AU - Lee, Shih Huang

AU - Chiu, Chiung Zuan

AU - Lo, Huey Ming

PY - 2010/2

Y1 - 2010/2

N2 - Introduction: Left circumflex (LC)-related acute myocardial infarction (AMI) presenting without ST-T changes has been underdiagnosed in the emergency department. There is little information on its clinical features and significance. Aims: The aims of the study were to investigate the clinical characteristics and outcomes of LC-related AMI without ST-T changes. Population and Methods: Ninety-six patients were admitted for LC-related AMI. Comparisons between those with and without ST-T changes were analyzed. Results: Twenty-two patients (23%) did not have ST-T changes, whereas 74 patients (77%) had them. Patients without ST-T changes had younger age (55.6 ± 16.8 vs 62.6 ± 12.0 years, P = .03), fewer presented as Killip III/IV (4.5% vs 27.4%, P = .02) and with lower creatine kinase (1647.3 ± 1602.2 vs 2778.2 ± 2343.3 IU/L, P = .037) and creatine kinase-MB (136.8 ± 130.3 vs 247.7 ± 200.0 IU/L, P = .017), and more were with concurrent culprit lesion in the middle or distal LC and right- or balanced-dominant coronary circulation (86.4% vs 44.6%, P <.001). During follow-up, the need for repeat percutaneous coronary intervention (48.6% vs 45.5%, P = .40) and recurrent infarction (13.5% vs 13.6%, P = .62) were similar between the 2 groups. The 30-day mortality (0% vs 5.4%, P = .35) and overall mortality rate (4.5% vs 12.2%, P = .28) between them were not different statistically. Conclusion: The relatively lower prevalence of LC-related AMI without ST-T changes in the study might be underestimated. These patients have smaller infarct size than patients with ST-T changes without differences in the short- and long-term outcomes between them.

AB - Introduction: Left circumflex (LC)-related acute myocardial infarction (AMI) presenting without ST-T changes has been underdiagnosed in the emergency department. There is little information on its clinical features and significance. Aims: The aims of the study were to investigate the clinical characteristics and outcomes of LC-related AMI without ST-T changes. Population and Methods: Ninety-six patients were admitted for LC-related AMI. Comparisons between those with and without ST-T changes were analyzed. Results: Twenty-two patients (23%) did not have ST-T changes, whereas 74 patients (77%) had them. Patients without ST-T changes had younger age (55.6 ± 16.8 vs 62.6 ± 12.0 years, P = .03), fewer presented as Killip III/IV (4.5% vs 27.4%, P = .02) and with lower creatine kinase (1647.3 ± 1602.2 vs 2778.2 ± 2343.3 IU/L, P = .037) and creatine kinase-MB (136.8 ± 130.3 vs 247.7 ± 200.0 IU/L, P = .017), and more were with concurrent culprit lesion in the middle or distal LC and right- or balanced-dominant coronary circulation (86.4% vs 44.6%, P <.001). During follow-up, the need for repeat percutaneous coronary intervention (48.6% vs 45.5%, P = .40) and recurrent infarction (13.5% vs 13.6%, P = .62) were similar between the 2 groups. The 30-day mortality (0% vs 5.4%, P = .35) and overall mortality rate (4.5% vs 12.2%, P = .28) between them were not different statistically. Conclusion: The relatively lower prevalence of LC-related AMI without ST-T changes in the study might be underestimated. These patients have smaller infarct size than patients with ST-T changes without differences in the short- and long-term outcomes between them.

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