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The impact of unsuccessful percutaneous coronary intervention on short- and long-term prognosis in STEMI and NSTEMI.
- Source :
-
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions [Catheter Cardiovasc Interv] 2011 Oct 01; Vol. 78 (4), pp. 514-22. Date of Electronic Publication: 2011 May 27. - Publication Year :
- 2011
-
Abstract
- Objectives: To compare the impact of the efficacy of percutaneous coronary intervention (PCI) on prognosis in ST and non-ST elevation myocardial infarction (STEMI and NSTEMI) patients with respect to infarct-related artery (IRA).<br />Background: The significance of the efficacy of PCI in STEMI and NSTEMI depending on the type of IRA has yet to be clarified.<br />Methods: Study population consisted of 2,179 STEMI and 554 NSTEMI consecutive patients treated with urgent PCI. The efficacy of PCI (TIMI [thrombolysis in myocardial infarction] 3 vs. TIMI < 3) was assessed with regard to the type of IRA (left anterior descending artery, circumflex artery [Cx] or right coronary artery). The mean follow-up was 37.5 months.<br />Results: The rate of unsuccessful PCI was similar in STEMI and NSTEMI irrespectively of IRA (14.1 vs. 17.7%; P = 0.062). In STEMI, unsuccessful PCI was associated with significantly higher early (23.1 vs. 5.6%; P < 0.001) and late (29.9 vs. 12.8%; P < 0.001) mortality regardless of IRA. In NSTEMI, the inefficacious PCI significantly increased early (19.0% vs. 0.9%; P < 0.001) and late (27.3% vs. 6.3%; P < 0.001) mortality only in patients with Cx-related infarction. Unsuccessful PCI of IRA was an independent risk factor for death in STEMI (HR 1.64; P < 0.05), but not in NSTEMI (P = 0.64). Further analysis showed that whilst unsuccessful PCI of any vessel in STEMI is an independent risk factor for death, in NSTEMI this applies to unsuccessful PCI of Cx only.<br />Conclusions: The significance of unsuccessful PCI of IRA seems to be different in STEMI and NSTEMI. Unsuccessful PCI is an independent risk factor for death in STEMI regardless of IRA and in NSTEMI with the involvement of Cx.<br /> (Copyright © 2010 Wiley-Liss, Inc.)
- Subjects :
- Aged
Angioplasty, Balloon, Coronary mortality
Chi-Square Distribution
Coronary Angiography
Female
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Myocardial Infarction diagnostic imaging
Myocardial Infarction mortality
Poland
Proportional Hazards Models
Registries
Regression Analysis
Risk Assessment
Risk Factors
Time Factors
Treatment Failure
Angioplasty, Balloon, Coronary adverse effects
Myocardial Infarction therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1522-726X
- Volume :
- 78
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
- Publication Type :
- Academic Journal
- Accession number :
- 21626653
- Full Text :
- https://doi.org/10.1002/ccd.22727