Risk stratification for 1 year survival based on characteristics identified in the early hours of acute myocardial infarction. The Western Washington Intracoronary Streptokinase Trial

Circulation
M L StadiusJ W Kennedy

Abstract

We evaluated the relationship between baseline factors defined at 4.6 +/- 2.1 hr after onset of acute myocardial infarction and 1 year survival in 245 patients entered in the Western Washington Intracoronary Streptokinase Trial. Univariate statistics identified a significant relationship between 10 of these factors and survival. Multivariate analysis identified three factors as being most closely related to survival: (1) left ventricular ejection fraction (LVEF) (p less than .0001), (2) treatment with streptokinase (p = .03), and (3) location of infarction (p = .04). Mathematic models based on this analysis and applied to our patients identified high- and low-risk subgroups for 1 year mortality. Patients receiving standard, not interventional, therapy with anterior infarction and an LVEF of 50% or less and those with inferior infarction and an LVEF of 39% or less comprised the high-risk group. For patients receiving standard therapy, 1 year mortality was 41% in the high-risk group and 4% in the low-risk group. The models illustrated the magnitude of benefit of streptokinase treatment and achievement of complete reperfusion for those at low and high risk. We conclude that LVEF determined in the first hours of acute myocardial in...Continue Reading

References

Aug 1, 1978·The American Journal of Cardiology·J T BiggerF M Weld
Aug 16, 1979·The New England Journal of Medicine·P ThérouxH F Mizgala
Dec 1, 1979·The American Journal of Cardiology·M A DeWoodR Grunwald
Dec 16, 1976·The New England Journal of Medicine·J S ForresterH J Swan
Jul 31, 1975·The New England Journal of Medicine·B J McNeilS J Adelstein
Nov 1, 1976·Annals of Internal Medicine·M H LuriaJ B Kuplic
Nov 1, 1971·Archives of Surgery·R PifarréJ R Tobin
Mar 1, 1969·Investigative Radiology·I S Kasser, J W Kennedy
Dec 15, 1983·The New England Journal of Medicine·J W KennedyJ K Fritz
Jul 1, 1984·The American Journal of Cardiology·J MukharjiD S Raabe
Aug 11, 1983·The New England Journal of Medicine·UNKNOWN Multicenter Postinfarction Research Group
May 6, 1982·The New England Journal of Medicine·G SanzF Navarro-López
Nov 1, 1962·British Heart Journal·A A PeelJ L Dall

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Citations

Sep 24, 1999·Clinical Cardiology·C P CannonR M Walls
May 1, 1994·Cardiovascular Drugs and Therapy·R ScognamiglioS Dalla Volta
Jan 1, 1994·Journal of Thrombosis and Thrombolysis·C P CannonE Braunwald
May 1, 1994·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·R O Bonow
Jun 1, 1988·Journal of the American College of Cardiology·E J Topol
Dec 1, 1988·Journal of the American College of Cardiology·E R Bates
Nov 1, 1989·Journal of the American College of Cardiology·R M CaliffB J Gersh
Dec 1, 1990·Journal of the American College of Cardiology·J Van LierdeF Van de Werf
Mar 1, 1990·Journal of the American College of Cardiology·G W StoneG O Hartzler
Sep 1, 1991·Journal of the American College of Cardiology·W D WeaverM S Wirkus
Dec 1, 1992·Journal of the American College of Cardiology·J R BengtsonR M Califf
Jan 6, 2001·Lancet·L KøberUNKNOWN Danish Investigations of Arrhythmia and Mortality on Dofetilide (DIAMOND) Study Group
Oct 7, 1989·Lancet·T R CrippsD E Ward
May 1, 1990·Journal of the American College of Cardiology·J Ferlinz
Oct 21, 2003·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Luigi AscioneBernardino Tuccillo
May 20, 1998·Clinical and Experimental Pharmacology & Physiology·S F BroschP Heistracher
Mar 4, 2008·Cardiology Clinics·Dhruv Kazi, Anita Deswal
Mar 28, 2007·Heart Failure Clinics·Dhruv Kazi, Anita Deswal
Jun 1, 1994·The American Journal of Medicine·C LandauR A Lange
Jun 1, 1992·International Journal of Cardiology·L Bouwels, D Hertzberger

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