Long-term survival after counterpulsation for medically refractory heart failure complicating myocardial infarction and cardiac surgery

1987 ◽  
Vol 8 (5) ◽  
pp. 490-502 ◽  
Author(s):  
D. L. Kuchar ◽  
T. J. Campbell ◽  
M. F. O'Rourke
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Cardiac Surgery ◽  
Term Survival ◽  
Long Term Survival ◽  
Refractory Heart Failure

scholarly journals Long-term survival benefit of ramipril in patients with acute myocardial infarction complicated by heart failure

Heart ◽  
2021 ◽  
Vol 107 (5) ◽  
pp. 389-395
Author(s):  
Jianhua Wu ◽  
Alistair S Hall ◽  
Chris P Gale
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Life Expectancy ◽  
Survival Benefit ◽  
Ace Inhibition ◽  
Survival Times ◽  
Term Survival ◽  
Long Term Survival

AimsACE inhibition reduces mortality and morbidity in patients with heart failure after acute myocardial infarction (AMI). However, there are limited randomised data about the long-term survival benefits of ACE inhibition in this population.MethodsIn 1993, the Acute Infarction Ramipril Efficacy (AIRE) study randomly allocated patients with AMI and clinical heart failure to ramipril or placebo. The duration of masked trial therapy in the UK cohort (603 patients, mean age=64.7 years, 455 male patients) was 12.4 and 13.4 months for ramipril (n=302) and placebo (n=301), respectively. We estimated life expectancy and extensions of life (difference in median survival times) according to duration of follow-up (range 0–29.6 years).ResultsBy 9 April 2019, death from all causes occurred in 266 (88.4%) patients in placebo arm and 275 (91.1%) patients in ramipril arm. The extension of life between ramipril and placebo groups was 14.5 months (95% CI 13.2 to 15.8). Ramipril increased life expectancy more for patients with than without diabetes (life expectancy difference 32.1 vs 5.0 months), previous AMI (20.1 vs 4.9 months), previous heart failure (19.5 vs 4.9 months), hypertension (16.6 vs 8.3 months), angina (16.2 vs 5.0 months) and age >65 years (11.3 vs 5.7 months). Given potential treatment switching, the true absolute treatment effect could be underestimated by 28%.ConclusionFor patients with clinically defined heart failure following AMI, ramipril results in a sustained survival benefit, and is associated with an extension of life of up to 14.5 months for, on average, 13 months treatment duration.

scholarly journals Impact of aspirin and statins on long-term survival in patients hospitalized with acute myocardial infarction complicated by heart failure: an analysis of 1706 patients

2013 ◽  
Vol 16 (1) ◽  
pp. 95-102 ◽  
Author(s):  
Christian Lewinter ◽  
John M. Bland ◽  
Simon Crouch ◽  
John G.F. Cleland ◽  
Patrick Doherty ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Term Survival ◽  
Long Term Survival

scholarly journals Donepezil Markedly Improves Long-Term Survival in Rats With Chronic Heart Failure After Extensive Myocardial Infarction

2013 ◽  
Vol 77 (10) ◽  
pp. 2519-2525 ◽  
Author(s):  
Meihua Li ◽  
Can Zheng ◽  
Toru Kawada ◽  
Masashi Inagaki ◽  
Kazunori Uemura ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Term Survival ◽  
Long Term Survival

Preemptive heme oxygenase-1 gene delivery reveals reduced mortality and preservation of left ventricular function 1 yr after acute myocardial infarction

2007 ◽  
Vol 293 (1) ◽  
pp. H48-H59 ◽  
Author(s):  
Xiaoli Liu ◽  
Jeremy A. Simpson ◽  
Keith R. Brunt ◽  
Christopher A. Ward ◽  
Sean R. R. Hall ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Gene Delivery ◽  
Heme Oxygenase ◽  
Left Ventricular ◽  
Heme Oxygenase 1 ◽  
Term Survival ◽  
Long Term Survival ◽  
Lv Remodeling

We reported previously that predelivery of heme oxygenase-1 (HO-1) gene to the heart by adeno-associated virus-2 (AAV-2) markedly reduces ischemia and reperfusion (I/R)-induced myocardial injury. However, the effect of preemptive HO-1 gene delivery on long-term survival and prevention of postinfarction heart failure has not been determined. We assessed the effect of HO-1 gene delivery on long-term survival, myocardial function, and left ventricular (LV) remodeling 1 yr after myocardial infarction (MI) using echocardiographic imaging, pressure-volume (PV) analysis, and histomorphometric approaches. Two groups of Lewis rats were injected with 2 × 1011 particles of AAV-LacZ (control) or AAV-human HO-1 (hHO-1) in the anterior-posterior apical region of the LV wall. Six weeks after gene transfer, animals were subjected to 30 min of ischemia by ligation of the left anterior descending artery followed by reperfusion. Echocardiographic measurements and PV analysis of LV function were obtained at 2 wk and 12 mo after I/R. One year after acute MI, mortality was markedly reduced in the HO-1-treated animals compared with the LacZ-treated animals. PV analysis demonstrated significantly enhanced LV developed pressure, elevated maximal dP/d t, and lower end-diastolic volume in the HO-1 animals compared with the LacZ animals. Echocardiography showed a larger apical anterior-to-posterior wall ratio in HO-1 animals compared with LacZ animals. Morphometric analysis revealed extensive myocardial scarring and fibrosis in the infarcted LV area of LacZ animals, which was reduced by 62% in HO-1 animals. These results suggest that preemptive HO-1 gene delivery may be useful as a therapeutic strategy to reduce post-MI LV remodeling and heart failure.

Abstract 3246: Skeletonization of Internal Thoracic Arteries: Is it Safe in Long-term?

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Arnaud Mommerot ◽  
Raymond Cartier
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Cox Regression ◽  
Wound Infection Rate ◽  
Cardiac Events ◽  
Term Survival ◽  
Long Term Survival ◽  
Cox Regression Analysis ◽  
Opcab Surgery

Background: Skeletonization of internal thoracic arteries (ITA) is a popular technique in OPCAB surgery to increase length of arterial conduit and feasibility of «No-touch» revascularization. Impact of skeletonized (SK) ITA on long-term survival and cardiac events is not clearly defined. Methods: We reviewed 1000 consecutive patients having undergone OPCAB surgery at the Montreal Heart Institute, between September 1996 and March 2004 that were prospectively recorded in an OPCAB database. Among them, 994 had at least one ITA bypass. Results: Skeletonized ITA was used in 558 patients (56.1%). SK patients were older (p=0.045), had significantly more risk factors [dyslipidemia (p<0.001), hypertension (p<0.001), obesity (p=0.002)]. Preoperative Parsonnet score was not different between SK and non-SK groups. Use of bilateral ITA (p<0.001) and sequential grafting (p<0.001) were more frequent in SK group (36.6% vs 25.7% and 29.9% vs 0.7%, respectively). Operative mortality was similar (SK: 1.8% vs non-SK: 1.6%; p=0.82). Sternal wound infection rate was similar, but dehiscence rate was higher in the PD group (p=0.03). Hospital (p=0.27) and ICU (p=0.09) length of stay were similar in both groups. Overall 7-year survival was 83±2% in SK group and 80±2% in non-SK group (p=0.84). Long-term freedom from major adverse cardiac events was also similar between SK and non-SK groups (83±2% and 82±2%, respectively, p=0.4). Late rate rehospitalization for heart failure or revascularization (CABG or PCI) was similar for both groups. However, 7-year freedom from myocardial infarction was significantly better for non-SK group (p=0.04). By Cox regression analysis, COPD, cardiac heart failure, peripheral vascular disease, emergency and completeness of revascularization were independent predictors of late mortality whereas diabetes, skeletonization and the number of grafts by territory of revascularization were independent predictors of late myocardial infarction. Conclusion: ITA has no influence in long-term survival or major cardiac events in an all comer OPCAB population. However, SK and diabetes were predictors of late incidence of myocardial infarction. Thus, a word of caution should be made about skeletonization of the ITA in diabetic population.

Sign in / Sign up

Export Citation Format

Share Document