Linked Life Data

21296327

Source:http://linkedlifedata.com/resource/pubmed/id/21296327

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
8
pubmed:dateCreated
2011-4-4
pubmed:abstractText
The clinical utility of new or "presumably new" left bundle branch block (LBBB) as an electrocardiographic criterion equivalent to ST-segment elevation myocardial infarction in contemporary practice is not well established. The aim of this study was to investigate the hypothesis that new or presumably new LBBB in symptomatic patients frequently leads to an overdiagnosis of acute myocardial infarction (AMI). A retrospective analysis of data from consecutive patients in the Mayo Clinic's ST-segment elevation myocardial infarction network from July 2004 to August 2009 was conducted among 892 patients, 36 (4%) of whom had new LBBB. The frequency, clinical characteristics, serum troponin levels, coronary angiographic findings, and outcomes of patients with new LBBB suspected of having AMI were evaluated. Compared with patients without LBBB (n = 856), those with new LBBB were older (64.5 vs 72.9 years, p < 0.001), had higher Thrombolysis In Myocardial Infarction (TIMI) risk scores (22.7 vs 31.0, p < 0.005), were less likely to undergo primary percutaneous coronary intervention (86% vs 22%, p < 0.001), and had longer door-to-balloon times. Only 14 patients (39%) had final diagnoses of acute coronary syndromes, of which 12 were AMI, while 13 (36%) had cardiac diagnoses other than acute coronary syndrome and 9 (25%) had noncardiac diagnoses. Of the patients with AMI, 5 had occluded culprit arteries, of which 2 involved the left anterior descending coronary artery. A Sgarbossa score ? 5 had low sensitivity (14%) but 100% specificity in diagnosing AMI in the presence of new LBBB. In conclusion, new or presumably new LBBB in patients suspected of having AMI identifies a high-risk subgroup, but only a small number have AMI. Two thirds of these patients are discharged from the hospital with alternative diagnoses. The Sgarbossa criteria appear to have limited utility in clinical practice because of their low sensitivity.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:status
MEDLINE
pubmed:month
Apr
pubmed:issn
1879-1913
pubmed:author
pubmed:copyrightInfo
Copyright © 2011 Elsevier Inc. All rights reserved.
pubmed:issnType
Electronic
pubmed:day
15
pubmed:volume
107
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1111-6
pubmed:meshHeading
pubmed:year
2011
pubmed:articleTitle
Utility of left bundle branch block as a diagnostic criterion for acute myocardial infarction.
pubmed:affiliation
Division of Cardiovascular Diseases and Department of Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA.
pubmed:publicationType
Journal Article, Comparative Study