New Predictors of Early and Late Outcomes after Primary Percutaneous Coronary Intervention in Patients with ST-Segment Elevation Myocardial Infarction and Unprotected Left Main Coronary Artery Culprit Lesion.
Age Factors
Aged
Coronary Vessels
/ diagnostic imaging
Female
Humans
Male
Middle Aged
Percutaneous Coronary Intervention
/ adverse effects
Prognosis
Retrospective Studies
Risk Assessment
Romania
/ epidemiology
ST Elevation Myocardial Infarction
/ diagnosis
Shock, Cardiogenic
/ diagnosis
Survival Analysis
Treatment Outcome
Journal
Journal of interventional cardiology
ISSN: 1540-8183
Titre abrégé: J Interv Cardiol
Pays: United States
ID NLM: 8907826
Informations de publication
Date de publication:
2019
2019
Historique:
received:
02
09
2018
accepted:
04
03
2019
entrez:
28
11
2019
pubmed:
28
11
2019
medline:
29
2
2020
Statut:
epublish
Résumé
The study evaluated the correlation between baseline SYNTAX Score, Residual SYNTAX Score, and SYNTAX Revascularization Index and long-term outcomes in ST-elevation myocardial infarction (STEMI) patients with primary percutaneous coronary intervention (PCI) on an unprotected left main coronary artery lesion (UPLMCA). Previous studies on primary PCI in UPLMCA have identified cardiogenic shock, TIMI 0/1 flow, and cardiac arrest, as prognostic factors of an unfavourable outcome, but the complexity of coronary artery disease and the extent of revascularization have not been thoroughly investigated in these high-risk patients. 30-day, 1-year, and long-term outcomes were analyzed in a cohort of retrospectively selected, 81 consecutive patients with STEMI, and primary PCI on UPLMCA. Cardiogenic shock (p=0.001), age (p=0.008), baseline SYNTAX Score II (p=0.006), and SYNTAX Revascularization Index (p=0.046) were independent mortality predictors at one-year follow-up. Besides cardiogenic shock (HR 3.28, p<0.001), TIMI 0/1 flow (HR 2.17, p=0.021) and age (HR 1.03, p=0.006), baseline SYNTAX Score II (HR 1.06, p=0.006), residual SYNTAX Score (HR 1.03, p=0.041), and SYNTAX Revascularization Index (HR 0.9, p=0.011) were independent predictors of mortality at three years of follow-up. In patients with TIMI 0/1 flow, the presence of Rentrop collaterals was an independent predictor for long-term survival (HR 0.24; p=0.049). In this study, the complexity of coronary artery disease and the extent of revascularization represent independent mortality predictors at long-term follow-up.
Sections du résumé
OBJECTIVES
OBJECTIVE
The study evaluated the correlation between baseline SYNTAX Score, Residual SYNTAX Score, and SYNTAX Revascularization Index and long-term outcomes in ST-elevation myocardial infarction (STEMI) patients with primary percutaneous coronary intervention (PCI) on an unprotected left main coronary artery lesion (UPLMCA).
BACKGROUND
BACKGROUND
Previous studies on primary PCI in UPLMCA have identified cardiogenic shock, TIMI 0/1 flow, and cardiac arrest, as prognostic factors of an unfavourable outcome, but the complexity of coronary artery disease and the extent of revascularization have not been thoroughly investigated in these high-risk patients.
METHODS
METHODS
30-day, 1-year, and long-term outcomes were analyzed in a cohort of retrospectively selected, 81 consecutive patients with STEMI, and primary PCI on UPLMCA.
RESULTS
RESULTS
Cardiogenic shock (p=0.001), age (p=0.008), baseline SYNTAX Score II (p=0.006), and SYNTAX Revascularization Index (p=0.046) were independent mortality predictors at one-year follow-up. Besides cardiogenic shock (HR 3.28, p<0.001), TIMI 0/1 flow (HR 2.17, p=0.021) and age (HR 1.03, p=0.006), baseline SYNTAX Score II (HR 1.06, p=0.006), residual SYNTAX Score (HR 1.03, p=0.041), and SYNTAX Revascularization Index (HR 0.9, p=0.011) were independent predictors of mortality at three years of follow-up. In patients with TIMI 0/1 flow, the presence of Rentrop collaterals was an independent predictor for long-term survival (HR 0.24; p=0.049).
CONCLUSIONS
CONCLUSIONS
In this study, the complexity of coronary artery disease and the extent of revascularization represent independent mortality predictors at long-term follow-up.
Identifiants
pubmed: 31772547
doi: 10.1155/2019/8238972
pmc: PMC6739789
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
8238972Informations de copyright
Copyright © 2019 Cãlin Homorodean et al.
Déclaration de conflit d'intérêts
None of the authors has any conflicts of interest to disclose.
Références
EuroIntervention. 2015 Oct;11(6):634-42
pubmed: 25308300
Eur Heart J. 2018 Jan 7;39(2):119-177
pubmed: 28886621
Am Heart J. 2010 Dec;160(6):995-1003, 1003.e1-8
pubmed: 21146650
Int Heart J. 2013;54(4):185-91
pubmed: 23924928
Singapore Med J. 2016 Jul;57(7):396-400
pubmed: 27439434
Catheter Cardiovasc Interv. 2012 Jun 1;79(7):1111-6
pubmed: 22234952
Cardiol J. 2013;20(2):190-6
pubmed: 23558878
EuroIntervention. 2017 Mar 20;12(16):1995-2000
pubmed: 27973327
Circulation. 2007 May 1;115(17):2344-51
pubmed: 17470709
Circ J. 2008 Oct;72(10):1598-604
pubmed: 18762703
JACC Cardiovasc Interv. 2011 Jun;4(6):627-33
pubmed: 21700248
JACC Cardiovasc Interv. 2014 Sep;7(9):969-80
pubmed: 25234669
Catheter Cardiovasc Interv. 2015 Feb 15;85(3):416-20
pubmed: 25322922
JACC Cardiovasc Interv. 2013 Apr;6(4):317-24
pubmed: 23597607
J Interv Cardiol. 2012 Jun;25(3):215-22
pubmed: 22360543
Am J Cardiol. 2011 Aug 1;108(3):355-9
pubmed: 21545992
Am J Cardiol. 2015 Jul 15;116(2):174-86
pubmed: 25983123
J Interv Cardiol. 2018 Apr;31(2):129-135
pubmed: 29148142
Heart. 2013 May;99(10):690-9
pubmed: 23539556
Int J Cardiol. 2004 Oct;97(1):73-6
pubmed: 15336810
Catheter Cardiovasc Interv. 2009 Feb 15;73(3):301-7
pubmed: 19213083
Eur Heart J. 2009 Oct;30(19):2308-17
pubmed: 19720640
JACC Cardiovasc Interv. 2017 Dec 11;10(23):2401-2410
pubmed: 29217002
JACC Cardiovasc Interv. 2011 Jun;4(6):618-26
pubmed: 21700247
Catheter Cardiovasc Interv. 2013 Sep 1;82(3):333-40
pubmed: 22936604
J Am Coll Cardiol. 1985 Mar;5(3):587-92
pubmed: 3156171