Chonnam Med J.  2007 Dec;43(3):197-202.

The Clinical Outcomes of Primary or Rescue Percutaneous Coronary Intervention in Acute Right Ventricular Infarction

• Hwang SH
• Jeong MH
• Kim W
• Kim HG
• Hong YJ
• Park HW
• Lim JH
• Jeong SY
• Kim IS
• Park OY
• Kim JH
• Kim W
• Ahn YK
• Cho JG
• Park JC
• Kang JC

Abstract

Right ventricular involvement is observed in 19 to 51% of patients with acute inferior myocardial infarction (AIMI). Right ventricular infarction (RVI) contributes to hemodynamic instability, atrioventricular conduction block and in-hospital mortality in patients with inferior myocardial infarction. The purpose of this study is to determine the difference for clinical effect of PCI in AIMI with or without RVI. We analyzed the clinical outcomes after primary or rescue percutaneous coronary intervention (PCI) in patients with RVI. Eighty three consecutive patients, underwent primary or rescue PCI for AIMI between January 2000 and February 2003 at Chonnam National University Hospital, were divided into two groups: Group I (22 patients, 66.3+/-12.1 years, 12 male : RVI) and Group II (61 patients, 65.1+/-12.5 years, 43 male : No RVI). In-hospital and 6-month major adverse cardiac events (MACE) were compared between the two groups. Baseline clinical characteristics were not different between the two groups. Peak level of creatine kinase-MB were 295+/-260 ng/mL in Group I and 166+/-153 ng/mL in Group II (p=0.017). Lesion type C according to ACC/AHA classification was more common in Group I than in Group II (59.1% vs. 23.0%, p=0.006). The percentage of TIMI 0 flow was higher in Group I than in Group II (95.5% vs. 57.4%, p=0.013). The stent length was significantly longer in Group I than Group II (p=0.035). The use of intraaortic balloon pumping was more common in Group I than in Group II (p=0.017). There was no significant difference in MACE during hospitalization and MACE-free survival rate between the two groups during six-month clinical follow-up. In conclusion, primary or rescue PCI was effective in patients with acute inferior myocardial infarction with or without RVI.

Keyword

Coronary diseases; Myocardial infarction; Angioplasty

MeSH Terms

Angioplasty
Atrioventricular Block
Classification
Coronary Disease
Creatine
Follow-Up Studies
Hemodynamics
Hospital Mortality
Hospitalization
Humans
Infarction*
Inferior Wall Myocardial Infarction
Intra-Aortic Balloon Pumping
Jeollanam-do
Male
Myocardial Infarction
Percutaneous Coronary Intervention*
Stents
Survival Rate
Creatine