Author + information
- Benjamin Bier,
- Heather Pemberton,
- Jason Matos,
- Ankur Kalra,
- Ara Tachjian,
- Michael Gavin and
- Duane Pinto
Background: False positive activation of the cardiac catheterization laboratory (CCL) for suspected ST Elevation Myocardial Infarction (STEMI) is common. Often, these activations are cancelled following further evaluation. Still, a substantial number of patients undergo angiography and are not found to have an angiographically apparent culprit lesion. The outcomes of these patients have not been thoroughly studied.
Methods: Between 2007-2011, we studied 256 consecutive CCL activations for STEMI at a single tertiary care medical center. Angiograms were reviewed to determine whether a culprit lesion was present. Mortality was evaluated for patients with and without culprit lesions.
Results: No culprit lesions were identified in 62 patients (24.2%). There was no significant difference in mortality between the two groups (Figure 1). Survival for those with a culprit lesion was 88.6% at 30 days and 84.0% at 1 year versus 90.3% and 87.1% for those without a culprit lesion (p-values of 0.723 and 0.580). Most common diagnoses for patients without culprit lesions included Idiopathic Chest Pain/Unknown (n=22), stable multivessel CAD (n=14), myopericarditis (n=9), heart failure (n=7), and Takotsubo cardiomyopathy (n=4).
Conclusions: Among patients with STEMI activation, patients with no angiographically apparent culprit lesions had similar 30 day and 1 year survival compared to those with a culprit lesion. The reasons for high mortality among those without culprit lesions requires further investigation.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Unusual Presentations of ACS
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1297-329
- 2017 American College of Cardiology Foundation