Coronary artery diseaseLeft Ventricular Remodeling After Anterior Wall Acute Myocardial Infarction in Modern Clinical Practice (from the REmodelage VEntriculaire [REVE] Study Group)
Section snippets
Methods
The REmodelage VEntriculaire (REVE) study was a multicenter study that enrolled 266 patients with anterior wall Q-wave AMI from 13 centers in the Region Nord Pas-de-Calais in France (see Appendix) between February 2002 and June 2004. Patients were considered eligible if the infarct zone comprised ≥3 LV segments that were akinetic on echocardiography before discharge. Exclusion criteria were inadequate echocardiographic image quality, age >85 years, life-limiting noncardiac disease, significant
Results
Baseline characteristics of the 266 patients who formed the study population are listed in Table 1. Most patients were men (mean age of 58.2 ± 13.8 years). In most cases, the index AMI was the first manifestation of coronary artery disease. Initial reperfusion therapy was intravenous thrombolysis in 142 patients and primary angioplasty in 78; 46 patients had no reperfusion therapy. Median time from symptom onset to reperfusion therapy was 4 hours but was longer in patients who underwent primary
Discussion
Our results demonstrate that LV remodeling remains a frequent event after anterior wall AMI, despite a therapeutic approach that includes a high rate of acute reperfusion strategies, quasi-systematic use of in-hospital angiography with subsequent percutaneous coronary intervention when indicated, and widespread prescription of antiremodeling medications.
In the present study, >80% of patients underwent thrombolysis or percutaneous coronary intervention as initial reperfusion therapy. Despite
Acknowledgment
The investigators thank Eleni Pelecanos, Michel Deneve, and Audrey Dusart for monitoring of the study and for help in the Lille Core Echocardiographic Laboratory.
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This study was supported by Grant PHRC 2001R/1918 from the CHRU de Lille, Lille, France, and the Fondation de France, Paris, France.