김계훈, 박종춘, 이우석, 윤남식, 황선호, 홍서나, 이상록, 홍영준, 박형욱, 김주한, 안영근, 정명호, 조정관, 강정채 |
Background and Objectives: The aim of this study was to investigate predictors of ventricular remodeling in patients with acute myocardial infarction (AMI) following successful percutaneous coronary intervention (PCI). Methods: A total of 135 patients with first episodes of AMI who was performed successful PCI were enrolled and divided into two groups: group I (remodeling group: 42 patients, 60.7±13.8 years old, 29 males), group II (non-remodeling group: 93 patients, 63.6±15.4 years old, 65 males). Clinical, laboratory, echocardiographic, and angiographic variables were analyzed between the groups. Results: Ventricular remodeling was developed in 42 patients (31.1%). Clinical characteristics were not different between the groups. Anterior wall MI was significantly frequent in group I than in group II (72.7 vs 48%, p=0.042). The level of N-terminal pro B-type natriuretic peptide (NT-pro BNP) at presentation, discharge, and 3 months were significantly higher in group I than in group II (3992.9±3159.1 vs 1229.5±1657.6 pg/ml at admission, p=0.043, 4678.4±3679.3 vs 1625.8±1672.7 pg/ml at discharge, p=0.037, 662.7±716.5 vs 257.0±74.2 pg/ml at 3 months, p=0.045). The level of peak creatinine kinase (CK), CK-MB, and cardiac troponin-i (cTni) was significantly elevated in group I than in group II (CK: 3002.3±2491.1 vs 1743.6±1811.8 U/L, p=0.023, CK-MB: 161.9±135.1 vs 92.2±105.1 U/L, p=0.026, cTni: 73.6±65.6 vs 42.2±39.8 ng/ml, p=0.045). On initial echocardiographic examination, total wall motion score (TWMS) (24.8±5.6 vs 21.1±3.4, p=0.001) was significantly higher and the presence of aneurysm (30 vs 4.1%, p=0.003) was significantly frequent in group I than in group II. Conclusion Our results demonstrated that the level of NT-pro BNP, peak CK, CK-MB, cTni, TWMS, aneurysm formation were significantly associated with ventricular remodeling following successful PCI in patients with first episodes of AMI.
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