Half of STEMI Heart Attack Patients May Have Additional Clogged Arteries
Durham, NC - In more than half of STEMI cases studied recently by Duke Medicine researchers, one or both of the patient’s other arteries were also obstructed, raising questions about whether and when additional procedures might be undertaken.
In a study to be published in the Nov. 19, 2014, issue of the Journal of the American Medical Association, Duke researchers and their colleagues report the first large analysis of how often these secondary blockages occur, along with evidence that they lead to worse outcomes.
The findings provide fodder for additional studies to determine whether opening all the blocked arteries -- either at the same time, or within a few days or weeks – should become a standard procedure.
“We assumed this was a common problem, but it has not been well understood or quantified,” said senior author Manesh Patel, M.D., director of Interventional Cardiology and Cardiac Catheterization Labs at Duke University Health System. “We found that more than half of the 28,000 patient scans we analyzed showed at least one additional blocked artery, and about 19 percent had blockages in all three arteries.”
In their retrospective study, Patel and colleagues analyzed eight large, international clinical trials of patients who suffered an ST segment elevation myocardial infarction, or STEMI heart attack. These serious heart attacks strike nearly 250,000 people in the United State a year, according to the American Heart Association.
The researchers analyzed angiograms for the patients to quantify how many had additional blockages in one of the other three arteries of the heart. While it has long been assumed that many patients would have additional blockages, the research team’s finding that 52.8 percent of patients had more than one blockage indicates the prevalence. Continue>
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