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Multicenter international registry of unprotected left main coronary artery percutaneous coronary intervention with drug-eluting stents in patients with myocardial infarction.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Lee, Michael S. Sillano, Dario Latib, Azeem Chieffo, Alaide Zoccai, Giuseppe Biondi Mediratta, Sunit Sheiban, Imad Colombo, A. Tobis, J. M. |
| Copyright Year | 2009 |
| Abstract | BACKGROUND Patients who present with myocardial infarction (MI) and unprotected left main coronary artery (ULMCA) disease represent an extremely high-risk subset of patients. ULMCA percutaneous coronary intervention (PCI) with drug-eluting stents (DES) in MI patients has not been extensively studied. METHODS In this retrospective multicenter international registry, we evaluated the clinical outcomes of 62 consecutive patients with MI who underwent ULMCA PCI with DES (23 ST-elevation MI [STEMI] and 39 non-ST-elevation MI [NSTEMI]) from 2002 to 2006. RESULTS The mean age was 70 +/- 12 years. Cardiogenic shock was present in 24%. The mean EuroSCORE was 10 +/- 8. Angiographic success was achieved in all patients. Overall in-hospital major adverse cardiac event (MACE) rate was 10%, mortality was 8%, all due to cardiac deaths from cardiogenic shock, and one patient suffered a periprocedural MI. At 586 +/- 431 days, 18 patients (29%) experienced MACE, 12 patients (19%) died (the mortality rate was 47% in patients with cardiogenic shock), and target vessel revascularization was performed in four patients, all of whom had distal bifurcation involvement (two patients underwent repeat PCI and two patients underwent bypass surgery). There was no additional MI. Two patients had probable stent thrombosis and one had possible stent thrombosis. Diabetes [hazard ratio (HR) 4.22, 95% confidence interval (CI) (1.07-17.36), P = 0.04), left ventricular ejection fraction [HR 0.94, 95% CI (0.90-0.98), P = 0.005), and intubation [HR 7.00, 95% CI (1.62-30.21), P = 0.009) were significantly associated with increased mortality. CONCLUSIONS Patients with MI and ULMCA disease represent a very high-risk subgroup of patients who are critically ill. PCI with DES appears to be technically feasible, associated with acceptable long-term outcomes, and a reasonable alternative to surgical revascularization for MI patients with ULMCA disease. Randomized trials are needed to determine the ideal revascularization strategy for these patients. |
| Starting Page | 15 |
| Ending Page | 21 |
| Page Count | 7 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://faculty.neuroscience.ucla.edu/institution/publication-download?publication_id=647896 |
| Alternate Webpage(s) | http://people.healthsciences.ucla.edu/institution/publication-download?publication_id=647896 |
| PubMed reference number | 19089930v1 |
| Alternate Webpage(s) | https://doi.org/10.1002/ccd.21712 |
| DOI | 10.1002/ccd.21712 |
| Journal | Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions |
| Volume Number | 73 |
| Issue Number | 1 |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Acute myocardial infarction Artificial cardiac pacemaker Cardiac Death Cessation of life Confidence Intervals Critical Illness Diabetes Mellitus Drug-Eluting Stents Ejection fraction (procedure) Hazard Ratio Intubation Left coronary artery structure Mortality Vital Statistics Non-ST Elevated Myocardial Infarction Patients Percutaneous Coronary Intervention Probability Registries ST segment elevation myocardial infarction Shock Shock, Cardiogenic Stent Device Component Stent, device Subgroup A Nepoviruses Thrombosis bypass revascularization |
| Content Type | Text |
| Resource Type | Article |
