Acute myocardial infarction and lesion location in the left circumflex artery: importance of coronary artery dominance
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Acute myocardial infarction and lesion location in the left circumflex artery : importance of coronary artery dominance. / Waziri, Homa; Jørgensen, Erik; Kelbæk, Henning; Fosbøl, Emil L.; Pedersen, Frantz; Mogensen, Ulrik M; Gerds, Thomas A.; Køber, Lars; Wachtell, Kristian.
I: EuroIntervention, Bind 12, Nr. 4, 07.2016, s. 441-448.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Acute myocardial infarction and lesion location in the left circumflex artery
T2 - importance of coronary artery dominance
AU - Waziri, Homa
AU - Jørgensen, Erik
AU - Kelbæk, Henning
AU - Fosbøl, Emil L.
AU - Pedersen, Frantz
AU - Mogensen, Ulrik M
AU - Gerds, Thomas A.
AU - Køber, Lars
AU - Wachtell, Kristian
N1 - PMID: 26348675
PY - 2016/7
Y1 - 2016/7
N2 - AIMS: Due to the limitations of 12-lead ECG, occlusions of the left circumflex artery (LCX) are more likely to present as non-ST-elevation acute coronary syndrome (NSTEACS) compared with other coronary arteries. We aimed to study mortality in patients with LCX lesions and to assess the importance of coronary artery dominance on triage of these patients.METHODS AND RESULTS: From the Eastern Danish Heart Registry, 3,632 NSTEACS and 3,907 ST-elevation myocardial infarction (STEMI) consecutive, single-vessel disease patients were included. LCX was the culprit in 25% of NSTEACS and 14% of STEMIs (p<0.001). LCX lesions presented predominantly as STEMI in left dominant coronary arteries compared with NSTEACS (46% vs. 30%, p<0.001). Higher 30-day mortality was found in LCX-STEMI compared with LCX-NSTEACS (HR 7.9, 95% CI: 3.2-19.7, p<0.001) with no difference in long-term mortality (HR 0.9, 95% CI: 0.7-1.2, p=0.5). LCX-NSTEACS were not associated with higher mortality compared with other NSTEACS lesions.CONCLUSIONS: The 12-lead ECG seems sufficient for triage of patients with LCX lesions as a majority of patients with a large LCX due to a dominant left coronary artery present as STEMI. Patients with LCX-NSTEACS do not have higher mortality compared with patients with LCX-STEMI or NSTEACS with lesions in other coronary territories.
AB - AIMS: Due to the limitations of 12-lead ECG, occlusions of the left circumflex artery (LCX) are more likely to present as non-ST-elevation acute coronary syndrome (NSTEACS) compared with other coronary arteries. We aimed to study mortality in patients with LCX lesions and to assess the importance of coronary artery dominance on triage of these patients.METHODS AND RESULTS: From the Eastern Danish Heart Registry, 3,632 NSTEACS and 3,907 ST-elevation myocardial infarction (STEMI) consecutive, single-vessel disease patients were included. LCX was the culprit in 25% of NSTEACS and 14% of STEMIs (p<0.001). LCX lesions presented predominantly as STEMI in left dominant coronary arteries compared with NSTEACS (46% vs. 30%, p<0.001). Higher 30-day mortality was found in LCX-STEMI compared with LCX-NSTEACS (HR 7.9, 95% CI: 3.2-19.7, p<0.001) with no difference in long-term mortality (HR 0.9, 95% CI: 0.7-1.2, p=0.5). LCX-NSTEACS were not associated with higher mortality compared with other NSTEACS lesions.CONCLUSIONS: The 12-lead ECG seems sufficient for triage of patients with LCX lesions as a majority of patients with a large LCX due to a dominant left coronary artery present as STEMI. Patients with LCX-NSTEACS do not have higher mortality compared with patients with LCX-STEMI or NSTEACS with lesions in other coronary territories.
UR - http://www.ncbi.nlm.nih.gov/pubmed/26348675
U2 - 10.4244/EIJY15M09_04
DO - 10.4244/EIJY15M09_04
M3 - Journal article
C2 - 26348675
VL - 12
SP - 441
EP - 448
JO - EuroIntervention
JF - EuroIntervention
SN - 1774-024X
IS - 4
ER -
ID: 157491104